Provider Demographics
NPI:1871595223
Name:KARIN, ROM RODNEY (MD)
Entity type:Individual
Prefix:
First Name:ROM
Middle Name:RODNEY
Last Name:KARIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15861 WINCHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-3306
Mailing Address - Country:US
Mailing Address - Phone:408-395-6121
Mailing Address - Fax:408-395-6127
Practice Address - Street 1:15861 WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-3306
Practice Address - Country:US
Practice Address - Phone:408-395-6121
Practice Address - Fax:408-395-6127
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG53047207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G530470Medicaid
CA00G530470Medicaid
A03277Medicare UPIN