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Roman G. Mcinnerney

Pediatrics

Allopathic & Osteopathic Physicians

3020 Childrens Way, San Diego, CA 92123-4223

PECOS Enrollment

This provider is enrolled in PECOS as ROMAN MCINNERNEY.

Based on the most recent information from CMS, provider Roman G. Mcinnerney is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 2:29 PM.

Profile Details

Provider ID
1205321163
Provider Type
Individual
Full Name
Mcinnerney, Roman G.
Title
Dr.
Credential
DO

Gender
Male
Sole Proprietor
No
Enumeration Date
6/24/2018
Last Updated
8/5/2025

Contact Information

Practice Location

3020 Childrens Way, San Diego, CA 92123-4223

(858) 966-8800

Unlisted Fax

Mailing Location

3020 Childrens Way # Mc5003, San Diego, CA 92123-4223

(858) 309-6300

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208000000X Primary	Description Pediatrics Allopathic & Osteopathic Physicians	License 20A17994 California
Code 207P00000X	Description Emergency Medicine Allopathic & Osteopathic Physicians	License T4000 Texas
Code 208000000X	Description Pediatrics Allopathic & Osteopathic Physicians	License T4000 Texas
Code 2080P0204X	Description Pediatrics Allopathic & Osteopathic Physicians	License 011878 Arizona

Roman G. Mcinnerney

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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