Provider Demographics
NPI:1679935381
Name:ASAGWARA, ROMMEL (MD,)
Entity type:Individual
Prefix:DR
First Name:ROMMEL
Middle Name:
Last Name:ASAGWARA
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 LARRABEE ST APT 2234
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4527
Mailing Address - Country:US
Mailing Address - Phone:312-532-3141
Mailing Address - Fax:323-973-2787
Practice Address - Street 1:8857 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-4534
Practice Address - Country:US
Practice Address - Phone:323-973-2787
Practice Address - Fax:323-973-2787
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2025-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS26900207P00000X
KS9409057207Q00000X
CAC200863207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine