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Individual

MR. DOMINIC MAGTAHAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
N.P.

Contact information

Practice address
8700 BEVERLY BLVD, BECKER BLDG 220, WEST HOLLYWOOD, CA 90048-1804
(310) 423-7800
Mailing address
9511 YOLANDA AVE, NORTHRIDGE, CA 91324-2256
(818) 523-3964

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95004891
CA

Other

Enumeration date
11/11/2016
Last updated
11/11/2016
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