Provider Demographics
NPI:1013155175
Name:ROVERAN, GIORGIO (MD)
Entity type:Individual
Prefix:
First Name:GIORGIO
Middle Name:
Last Name:ROVERAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2045 COMPTON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-7286
Mailing Address - Country:US
Mailing Address - Phone:951-817-8820
Mailing Address - Fax:951-817-8856
Practice Address - Street 1:26001 REDLANDS BLVD
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-7762
Practice Address - Country:US
Practice Address - Phone:909-825-7084
Practice Address - Fax:909-894-7961
Is Sole Proprietor?:No
Enumeration Date:2009-01-28
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA106675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine