Provider Demographics
NPI:1750842076
Name:ERSNO EROMO, MD INC
Entity Type:Organization
Organization Name:ERSNO EROMO, MD INC
Other - Org Name:CONCIERGE HEALTHCARE PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERSNO
Authorized Official - Middle Name:
Authorized Official - Last Name:EROMO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-704-9880
Mailing Address - Street 1:8447 WILSHIRE BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3207
Mailing Address - Country:US
Mailing Address - Phone:310-704-9880
Mailing Address - Fax:
Practice Address - Street 1:1400 S GRAND AVE STE 707
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-2881
Practice Address - Country:US
Practice Address - Phone:310-929-6336
Practice Address - Fax:877-797-3623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03375844Medicaid