Individual
DOMINIQUE M. DELVECCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2716 OCEAN PARK BLVD. SUITE 3082, INSTITUTE FOR NERVE MEDICINE, SANTA MONICA, CA 90405
(310) 314-6410
(310) 314-2414
Mailing address
2716 OCEAN PARK BLVD. SUITE 3082, INSTITUTE FOR NERVE MEDICINE, SANTA MONICA, CA 90405
(310) 314-6410
(310) 314-2414
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
23581
CA
363LG0600X
Gerontology Nurse Practitioner
23581
CA
363LP2300X
Primary Care Nurse Practitioner
23581
CA
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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