Provider Demographics
NPI:1184340002
Name:ALCANTARA, ROMMEL ILDE GOMEZ (RN, MSN, PHN, NP-C)
Entity type:Individual
Prefix:MR
First Name:ROMMEL ILDE
Middle Name:GOMEZ
Last Name:ALCANTARA
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Gender:M
Credentials:RN, MSN, PHN, NP-C
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Mailing Address - Street 1:3939 ATLANTIC AVENUE
Mailing Address - Street 2:SUITE 216
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807
Mailing Address - Country:US
Mailing Address - Phone:562-787-4271
Mailing Address - Fax:562-424-8832
Practice Address - Street 1:3939 ATLANTIC AVENUE
Practice Address - Street 2:SUITE 216
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807
Practice Address - Country:US
Practice Address - Phone:562-787-4271
Practice Address - Fax:562-424-8832
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
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Provider Licenses
StateLicense IDTaxonomies
CA95017590363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily