Individual
SHIRLEY ROSE RAMISCAL DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1700 COFFEE RD, MODESTO, CA 95355-2803
(209) 526-4500
Mailing address
220 STANDIFORD AVE STE F, MODESTO, CA 95350-1159
(209) 661-4410
(209) 579-5637
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301082981
MI
208600000X
Surgery Physician
Primary
MDR-5205
HI
Other
Enumeration date
04/02/2007
Last updated
12/13/2021
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