Provider Demographics
NPI:1982625018
Name:MUNOZ DEL ROMERAL, LUISA (MD)
Entity Type:Individual
Prefix:
First Name:LUISA
Middle Name:
Last Name:MUNOZ DEL ROMERAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 WEBSTER ST
Mailing Address - Street 2:SUITE 404-410
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3117
Mailing Address - Country:US
Mailing Address - Phone:510-549-4220
Mailing Address - Fax:510-433-0744
Practice Address - Street 1:3300 WEBSTER ST
Practice Address - Street 2:SUITE 404-410
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3117
Practice Address - Country:US
Practice Address - Phone:510-549-4220
Practice Address - Fax:510-433-0744
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63860207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A638600Medicaid
CA00A638600Medicaid
CA00A638600Medicare ID - Type Unspecified