Individual
IVAN R ROMERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
9305 W THOMAS RD, SUITE 275, PHOENIX, AZ 85037-3328
(623) 327-4144
(623) 327-4140
Mailing address
1010 N COUNTRY CLUB DR, MESA, AZ 85201-3309
(480) 461-2409
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2988
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
859126
—
AZ
Enumeration date
03/16/2006
Last updated
03/17/2008
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