Provider Demographics
NPI:1841180569
Name:ROMBRO, BENJAMIN M (LAC)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:M
Last Name:ROMBRO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:BENJAMIN
Other - Middle Name:
Other - Last Name:ROMBRO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:2916 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5522
Mailing Address - Country:US
Mailing Address - Phone:646-251-0087
Mailing Address - Fax:
Practice Address - Street 1:2916 HARRISON ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5522
Practice Address - Country:US
Practice Address - Phone:646-251-0087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-04
Last Update Date:2025-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC00020066171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist