Individual
DOMINIQUE PAKINGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
141 S KNOTT AVE, ANAHEIM, CA 92804-1406
(714) 821-7310
Mailing address
10811 CARLA PL, CERRITOS, CA 90703-1504
(562) 569-9886
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA49311
CA
Other
Enumeration date
07/19/2021
Last updated
07/20/2021
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