Individual
DOMINIQUE FITRIA SUKANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22942 EL TORO RD, LAKE FOREST, CA 92630-4961
(510) 317-1444
Mailing address
22942 EL TORO RD, LAKE FOREST, CA 92630-4961
(510) 317-1444
Taxonomy
Speciality
Code
Description
License number
State
2470A2800X
Assistant Health Information Record Technician
Primary
—
—
Other
Enumeration date
08/07/2019
Last updated
02/09/2023
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