Provider Demographics
NPI:1821077280
Name:ROMAN, NORA LAHAM (MD)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:LAHAM
Last Name:ROMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 SALMON FALLS RD
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9787
Mailing Address - Country:US
Mailing Address - Phone:916-933-0199
Mailing Address - Fax:916-939-0145
Practice Address - Street 1:888 SALMON FALLS RD
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9787
Practice Address - Country:US
Practice Address - Phone:916-933-0199
Practice Address - Fax:916-939-0145
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44341207L00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G443410Medicaid
CA00G443410Medicare PIN
CA00G443410Medicaid