Organization
EDWARD J. DOMANSKIS,MD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD DOMANSKIS MD (MD)
(415) 331-8390
Entity
Organization
Contact information
Practice address
1441 AVOCADO AVE, SUITE 307, NEWPORT BEACH, CA 92660-7721
(949) 640-9324
Mailing address
175 N REDWOOD DR, SUITE 275, SAN RAFAEL, CA 94903-1972
(415) 331-8390
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
G22703
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023139128
TYPE 1 NPI
CA
Enumeration date
03/19/2013
Last updated
03/19/2013
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