Individual
MR. EMIL R DOMINGUEZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
409 E MERCED AVE, SUITE #A, WEST COVINA, CA 91790-5061
(626) 931-0901
(626) 931-0905
Mailing address
409 E MERCED AVE, SUITE #A, WEST COVINA, CA 91790-5061
(626) 931-0901
(626) 931-0905
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A43966
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A439660
—
CA
Enumeration date
12/15/2006
Last updated
07/09/2007
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