Individual
DR. DOMINIC OMAR ANSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
800 E WASHINGTON BLVD, CRESCENT CITY, CA 95531-8359
(707) 464-8511
Mailing address
300 LENORA ST # 101, SEATTLE, WA 98121-2411
(512) 766-7512
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
285015
NY
Other
Enumeration date
06/13/2011
Last updated
05/29/2019
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