Individual
MR. ROMEO REYES LADERO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
38340 INNOVATION CT # D-404, MURRIETA, CA 92563-2621
(951) 721-2768
Mailing address
38340 INNOVATION CT # D-404, MURRIETA, CA 92563-2621
(951) 721-2768
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
95008999
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356869846
—
CA
Enumeration date
09/05/2017
Last updated
06/05/2024
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