Individual
DOMINIQUE HYSMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
24452 HEALTH CENTER DR, LAGUNA HILLS, CA 92653-3604
(949) 837-8000
Mailing address
119 HUNTINGTON, IRVINE, CA 92620-3790
(951) 660-9396
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9735
CA
Other
Enumeration date
02/02/2023
Last updated
02/02/2023
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