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Organization
DERM-AUTHORITY GROUP LLC
Active
Organization
DERM-AUTHORITY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN DOMINGUEZ MD (PRESIDENT)
(714) 876-5476
Entity
Organization
Contact information
Practice address
13372 NEWPORT AVE STE A, TUSTIN, CA 92780-3426
(714) 761-3901
(714) 821-6392
Mailing address
13372 NEWPORT AVE STE A, TUSTIN, CA 92780-3426
(714) 761-3901
(714) 821-6392
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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