Provider Demographics
NPI:1093755589
Name:HAIDER, ROMANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROMANA
Middle Name:
Last Name:HAIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9613 KIRKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-4009
Mailing Address - Country:US
Mailing Address - Phone:310-838-8842
Mailing Address - Fax:310-838-8842
Practice Address - Street 1:2428 SANTA MONICA BLVD
Practice Address - Street 2:402
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2045
Practice Address - Country:US
Practice Address - Phone:310-829-3385
Practice Address - Fax:310-828-6635
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78716173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine