Individual
ANGELINE LOBERIANO DOMAGAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 702-4575
Mailing address
25016 ROCKSTON DR, CORONA, CA 92883-1622
(909) 702-4575
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95027030
CA
Other
Enumeration date
09/06/2023
Last updated
09/12/2023
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