Healthcare Provider Details

I. General information

NPI: 1639360613
Provider Name (Legal Business Name): AARON J DOMINGUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W CYPRESS AVE
REEDLEY CA
93654-2096
US

IV. Provider business mailing address

1479 W LACEY BLVD
HANFORD CA
93230-5906
US

V. Phone/Fax

Practice location:
  • Phone: 559-637-2455
  • Fax: 559-637-2459
Mailing address:
  • Phone: 559-583-4617
  • Fax: 559-583-4625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA91370
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: