Individual
CARLOS ALBERTO DOMINGUEZ GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1719
(215) 590-1771
Mailing address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1719
(215) 590-1771
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
PGC000165
PA
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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