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Organization
LOS NINOS CHILDREN MEDICAL CLINIC INC.
Active
Organization
LOS NINOS CHILDREN MEDICAL CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMIL R DOMINGUEZ JR. M.D. (PRESIDENT)
(626) 850-5005
Entity
Organization
Contact information
Practice address
409 E MERCED AVE, SUITE A, WEST COVINA, CA 91790-5061
(626) 931-0901
(626) 931-0905
Mailing address
409 E MERCED AVE, SUITE A, WEST COVINA, CA 91790-5061
(626) 931-0901
(626) 931-0905
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A43966
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A439660
—
CA
Enumeration date
12/22/2009
Last updated
12/22/2009
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