Individual
MELANIE DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13995 W STATLER BLVD STE 150, SURPRISE, AZ 85374-5512
(805) 560-4464
Mailing address
13995 W STATLER BLVD STE 150, SURPRISE, AZ 85374-5512
(805) 560-4464
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9239
AZ
Other
Enumeration date
01/25/2021
Last updated
01/11/2025
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