Provider Demographics
NPI:1669738316
Name:ROMO, NOEL (DC)
Entity type:Individual
Prefix:DR
First Name:NOEL
Middle Name:
Last Name:ROMO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22551 2ND ST
Mailing Address - Street 2:SUITE #242
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-4128
Mailing Address - Country:US
Mailing Address - Phone:510-300-4035
Mailing Address - Fax:
Practice Address - Street 1:22551 2ND ST
Practice Address - Street 2:SUITE #242
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4128
Practice Address - Country:US
Practice Address - Phone:510-300-4035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 32268111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor