Provider Demographics
NPI:1508591330
Name:ROMERO, CHRISTOPER JOSEPH (LMT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPER
Middle Name:JOSEPH
Last Name:ROMERO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6873 EMERALD AVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-1524
Mailing Address - Country:US
Mailing Address - Phone:602-388-5648
Mailing Address - Fax:
Practice Address - Street 1:6873 EMERALD AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-1524
Practice Address - Country:US
Practice Address - Phone:602-388-5648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-17
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85591225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty