Provider Demographics
NPI:1902967680
Name:ROMMAN, FAYEZ (MD)
Entity type:Individual
Prefix:
First Name:FAYEZ
Middle Name:
Last Name:ROMMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 581231
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-0021
Mailing Address - Country:US
Mailing Address - Phone:916-974-7782
Mailing Address - Fax:
Practice Address - Street 1:8001 BRUCEVILLE RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2329
Practice Address - Country:US
Practice Address - Phone:916-288-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA799832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H58701Medicare UPIN
00A799830Medicare ID - Type Unspecified