Healthcare Provider Details

I. General information

NPI: 1598151771
Provider Name (Legal Business Name): INESSA DOMBROVSKY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 ALESSANDRO PL STE 210
PASADENA CA
91105-4005
US

IV. Provider business mailing address

50 ALESSANDRO PL STE 210
PASADENA CA
91105-4005
US

V. Phone/Fax

Practice location:
  • Phone: 626-514-0060
  • Fax: 626-514-0062
Mailing address:
  • Phone: 626-514-0060
  • Fax: 626-514-0062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20A14942
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number20A14942
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: