Individual
ARDEE BUTAC DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
27001 MOULTON PKWY, LAGUNA HILLS, CA 92656-3600
(949) 600-1907
Mailing address
167 VALLEY VIEW TER, MISSION VIEJO, CA 92692-4088
(949) 510-8934
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95027092
CA
Other
Enumeration date
01/25/2024
Last updated
01/25/2024
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