Provider Demographics
NPI:1316934797
Name:FERNANDEZ, ROMMIL L (DC)
Entity type:Individual
Prefix:DR
First Name:ROMMIL
Middle Name:L
Last Name:FERNANDEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 W OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2216
Mailing Address - Country:US
Mailing Address - Phone:818-848-2225
Mailing Address - Fax:818-848-2227
Practice Address - Street 1:1220 W OLIVE AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2216
Practice Address - Country:US
Practice Address - Phone:818-848-2225
Practice Address - Fax:818-848-2227
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 29479111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor