Individual
NOEL DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1455 3RD AVE, SAN BERNARDINO, CA 92408-0218
(909) 382-7100
Mailing address
22373 BLUE LUPINE CIR, GRAND TERRACE, CA 92313-5466
(909) 851-2565
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95002720
CA
Other
Enumeration date
07/22/2015
Last updated
03/17/2018
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