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Individual
KATHLEEN H DOMINGUEZ
Active
Individual
KATHLEEN H DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
PA 17714
CA
363A00000X
Physician Assistant
Primary
PA17714
CA
Other
Enumeration date
08/30/2006
Last updated
10/28/2019
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