Individual
MIGUEL A DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18102 IRVINE BLVD, SUITE 208, TUSTIN, CA 92780-3402
(714) 371-9000
(714) 730-2720
Mailing address
18102 IRVINE BLVD, SUITE 208, TUSTIN, CA 92780-3402
(714) 371-9000
(714) 730-2720
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G64086
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
G64086
CA
Other
Enumeration date
06/09/2006
Last updated
01/21/2010
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