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Organization
MIGUEL DOMINGUEZ MD, A PROFESSIONAL CORPORATION
Active
Organization
MIGUEL DOMINGUEZ MD, A PROFESSIONAL CORPORATION
Active
Parent organization
MIGUEL DOMINGUEZ MD, A PROFESSIONAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIGUEL DOMINGUEZ MD, A PROFESSIONAL CORPORATION
Authorized official
DR. MIGUEL DOMINGUEZ M.D. (CEO)
(714) 371-9000
Entity
Organization
Contact information
Practice address
18102 IRVINE BLVD, STE 208, TUSTIN, CA 92780-3402
(714) 371-9000
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
NULL
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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