Provider Demographics
NPI:1649362013
Name:ROMAN, MAHER (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:MAHER
Middle Name:
Last Name:ROMAN
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11812 LANDSDOWN RD
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-4162
Mailing Address - Country:US
Mailing Address - Phone:909-226-1815
Mailing Address - Fax:
Practice Address - Street 1:5900 BROCKTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-1862
Practice Address - Country:US
Practice Address - Phone:951-275-8400
Practice Address - Fax:951-275-8402
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49869207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine