Individual
DR. LIZA DOMINGUEZ CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3650 E. SOUTH ST, SUITE 308, LAKEWOOD, CA 90712
(562) 633-2204
(562) 633-2579
Mailing address
PO BOX 14642, LONG BEACH, CA 90853-4642
(562) 633-2204
(562) 633-2579
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
G76279
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G762790
—
CA
Enumeration date
09/27/2006
Last updated
09/29/2011
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