Healthcare Provider Details

I. General information

NPI: 1821883273
Provider Name (Legal Business Name): DOMINIC ERIC MACHADO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DOMINIC ERIC RODRIGUEZ

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W PUEBLO ST
SANTA BARBARA CA
93105-4353
US

IV. Provider business mailing address

9454 MAGNOLIA CT APT 2A
OZONE PARK NY
11417-2974
US

V. Phone/Fax

Practice location:
  • Phone: 805-569-7464
  • Fax:
Mailing address:
  • Phone: 213-603-0731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: