Individual
ILIANA DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-8888
Mailing address
4225 DUANE WAY, SOUTH GATE, CA 90280-4903
(323) 973-3273
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95013270
CA
363LF0000X
Family Nurse Practitioner
95013270
CA
Other
Enumeration date
04/11/2020
Last updated
04/29/2025
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