Provider Demographics
NPI:1952429748
Name:ROMERO, AL VINCENT DOMONDON (OD)
Entity Type:Individual
Prefix:DR
First Name:AL VINCENT
Middle Name:DOMONDON
Last Name:ROMERO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6593 ACEY ST
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92880-3476
Mailing Address - Country:US
Mailing Address - Phone:909-753-7126
Mailing Address - Fax:909-590-2715
Practice Address - Street 1:3943 GRAND AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5440
Practice Address - Country:US
Practice Address - Phone:909-590-0921
Practice Address - Fax:909-590-2715
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12695T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist