Individual
MR. EDWARD DE GUZMAN DOMANTAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1114 WILLOW ST, B, ALAMEDA, CA 94501-4374
(510) 864-0763
Mailing address
1114 WILLOW ST, B, ALAMEDA, CA 94501-4374
(510) 864-0763
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT8381
CA
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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