Provider Demographics
NPI:1023426905
Name:HALOG, PAUL WINSTON ROMERO (RPT)
Entity type:Individual
Prefix:MR
First Name:PAUL WINSTON
Middle Name:ROMERO
Last Name:HALOG
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3238 OAKLEAF CT
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-2435
Mailing Address - Country:US
Mailing Address - Phone:909-680-2869
Mailing Address - Fax:909-606-9492
Practice Address - Street 1:3238 OAKLEAF CT
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-2435
Practice Address - Country:US
Practice Address - Phone:909-680-2869
Practice Address - Fax:909-606-9492
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA29741225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist