Individual
NOEL E SANTO DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
719 SOUTHPOINT BLVD, STE B, PETALUMA, CA 94954-1495
(707) 778-8421
(707) 778-1702
Mailing address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
(707) 573-6166
(707) 573-6165
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G79253
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00977322
RAILROAD MEDICARE
CA
01
—
P01719259
RAILROAD MEDICARE
CA
Enumeration date
08/19/2005
Last updated
11/10/2021
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