Individual
DIANA JAQUELINE ROMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6570 KAISER AVE, FONTANA, CA 92336-3260
(909) 489-0518
Mailing address
6570 KAISER AVE, FONTANA, CA 92336-3260
(909) 489-0518
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
54609
CA
Other
Enumeration date
07/18/2017
Last updated
07/18/2017
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