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Individual

GREGORIO DOMINGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
HHP

Contact information

Practice address
746 S MAIN AVE STE D, FALLBROOK, CA 92028-3352
(760) 728-8999
(760) 728-0821
Mailing address
746 S MAIN AVE STE D, FALLBROOK, CA 92028-3352
(760) 728-8999
(760) 728-0821

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
46608
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
46608
CERTIFIED MASSAGE THERAPIST
CA
Enumeration date
11/02/2015
Last updated
11/02/2015
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