Provider Demographics
NPI:1558496455
Name:VILLAR, ROMEO D (MD)
Entity Type:Individual
Prefix:DR
First Name:ROMEO
Middle Name:D
Last Name:VILLAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:268 W HOSPITALITY LN
Mailing Address - Street 2:STE. 400
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92415-0001
Mailing Address - Country:US
Mailing Address - Phone:909-382-3087
Mailing Address - Fax:909-382-3106
Practice Address - Street 1:268 W HOSPITALITY LN
Practice Address - Street 2:STE. 400
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-0001
Practice Address - Country:US
Practice Address - Phone:909-382-3087
Practice Address - Fax:909-382-3106
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA372712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry