Individual
JONATHAN MICHAEL DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2640 INDUSTRY WAY, LYNWOOD, CA 90262-4284
(310) 627-4525
Mailing address
2640 INDUSTRY WAY, LYNWOOD, CA 90262-4284
(310) 627-4525
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
07/02/2025
Last updated
07/02/2025
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