Individual
ADELINE DOMKAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3031 W MARCH LN STE 101, STOCKTON, CA 95219-6568
(209) 472-7100
Mailing address
3031 W MARCH LN STE 101, STOCKTON, CA 95219-6568
(209) 472-7100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F01220784
CA
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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