Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 14779 | HI |
NPI | 1508895210 |
---|---|
Provider Name | Dr. Celia E. Dominguez |
First Address | Honolulu, HI 96826-1001 |
Second Address | Honolulu, HI 96826-1001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 08/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E87073 | (02) | GA |