Healthcare Provider Details

I. General information

NPI: 1487997334
Provider Name (Legal Business Name): DOMINICK FIGUEROA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W WILLOW ST STE 101
LONG BEACH CA
90806-2831
US

IV. Provider business mailing address

500 W WILLOW ST STE 101
LONG BEACH CA
90806-2831
US

V. Phone/Fax

Practice location:
  • Phone: 562-427-1700
  • Fax:
Mailing address:
  • Phone: 562-427-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME128274
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA162689
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: