Individual provider Active NPI

Rommel Geronimo, DC

  • Chiropractor
  • Poway, CA
National Provider Identifier
1629147079
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC28665 Issued in CA
Practice address
13323 Poway Rd
Poway, CA 92064-4625
Phone
(858) 748-7703
Fax
(858) 748-7703
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC28665 CA Primary

Addresses

Primary practice location

13323 Poway Rd
Poway, CA 92064-4625

Mailing address

13323 Poway Rd
Poway, CA 92064-4625
Phone (858) 748-7703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629147079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13323 POWAY RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644625",
            "telephone_number": "858-748-7703",
            "fax_number": "858-748-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13323 POWAY RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644625",
            "telephone_number": "858-748-7703",
            "fax_number": "858-748-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERONIMO",
        "first_name": "ROMMEL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.