Provider Demographics
NPI:1710319447
Name:ROMANA, BHUPINDER SINGH (MD)
Entity Type:Individual
Prefix:
First Name:BHUPINDER
Middle Name:SINGH
Last Name:ROMANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 230
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95241-0230
Mailing Address - Country:US
Mailing Address - Phone:209-956-9166
Mailing Address - Fax:
Practice Address - Street 1:1144 NORMAN DR STE 203
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-5960
Practice Address - Country:US
Practice Address - Phone:209-405-2406
Practice Address - Fax:209-956-9180
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
MO2013020348207R00000X
CAA156389207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine