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General NPI Number Information
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NPI Number | 1023797321
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Entity Type | Individual
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Provider Name | DOMINICK REY AMPARANO
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Gender | Male
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Dates
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Enumeration Date | 07/13/2023
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 18300 ROSCOE BLVD
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City | NORTHRIDGE
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State | CA
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Zip | 91325-4167
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Country | US
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Telephone | 818-885-8500
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Fax | 818-727-0893
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Provider Business Mailing Address
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Address Line | 409 SPRINGFIELD CT
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City | BRENTWOOD
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State | CA
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Zip | 94513-2422
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Country | US
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Telephone | 415-720-6489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95025957
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License Number State | CA
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