Mario Jose Dominguez
Occupational Health
2900 Bristol St Bldg C, Suite 101
Costa Mesa
, California 92626-5981
Mario Jose Dominguez
Occupational Health
2900 Bristol St Bldg C, Suite 101
Costa Mesa
, California 92626-5981
(714) 540-0455
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About
Features
Specialties
- Occupational Health
Languages spoken
- English
Location
First Address
- Mario Jose Dominguez
- 2900 Bristol St Bldg C, Suite 101
- Costa Mesa, CA
- Zip : 92626-5981
- Fax : (714) 540-0455
- Phone : (714) 540-0555
Second Address
- Mario Jose Dominguez
- 2900 Bristol St Bldg C, Suite 101
- Costa Mesa, CA
- Zip : 92626-5981
- Fax : (714) 540-0455
- Phone : (714) 540-0555
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NX0100X | Occupational Health | DC17103 | CA |
National Provider Identifier
| NPI | 1912191495 |
|---|---|
| Provider Name | Mario Jose Dominguez |
| First Address | Costa Mesa, CA 92626-5981 |
| Second Address | Costa Mesa, CA 92626-5981 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/08/2007 |
| Last Update Date | 28/08/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.