Individual
DOMINIC ERMIE DEOGRACIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
9254 WINNETKA AVE APT 535, CHATSWORTH, CA 91311-8190
(424) 382-9829
Mailing address
9254 WINNETKA AVE APT 535, CHATSWORTH, CA 91311-8190
(424) 382-9829
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
95171961
CA
Other
Enumeration date
01/17/2022
Last updated
01/18/2022
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