Organization
L M DOMINGUEZ PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS M DOMINGUEZ MD (OWNER)
(480) 596-8525
Entity
Organization
Contact information
Practice address
8144 E CACTUS RD, SUITE 800, SCOTTSDALE, AZ 85260-5266
(480) 596-8525
(480) 596-8522
Mailing address
PO BOX 26904, PHOENIX, AZ 85068-6904
(480) 596-8525
(480) 596-8522
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16386
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0766790
BCBS
AZ
05
—
286866
—
AZ
01
—
AW6904
HEALTHNET
—
Enumeration date
04/09/2008
Last updated
04/17/2008
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