Provider Demographics
NPI:1164463386
Name:DAVID, ROMEO C (MD)
Entity Type:Individual
Prefix:DR
First Name:ROMEO
Middle Name:C
Last Name:DAVID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MRS
Other - First Name:ROMEO
Other - Middle Name:C
Other - Last Name:DAVID
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:225 SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-3631
Mailing Address - Country:US
Mailing Address - Phone:650-588-2240
Mailing Address - Fax:650-588-7279
Practice Address - Street 1:225 SPRUCE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-3631
Practice Address - Country:US
Practice Address - Phone:650-588-2240
Practice Address - Fax:650-588-7279
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53612207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine