Individual
BREVIN JOSEPH DOMINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
309 E 2ND ST, POMONA, CA 91766-1854
(909) 623-6116
Mailing address
309 E 2ND ST, POMONA, CA 91766-1854
(909) 623-6116
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA65205
CA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/09/2024
Last updated
01/09/2025
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