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NPI Code Detail

MEDICARE: DASON DOMINGUEZ DPT

MEDICARE:   DASON  DOMINGUEZ  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist304955CA

General Provider Information

NPI Number : 1558119693
Entity Type Code : Individual
Provider Name (Legal Business Name) : DASON DOMINGUEZ DPT
Provider Business Mailing Address
First Line : 285 W CALIFORNIA BLVD APT 3
Second Line :
City : PASADENA
State : CA
Zip : 91105-2950
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5806 PACIFIC BLVD
Second Line :
City : HUNTINGTON PARK
State : CA
Zip : 90255-2618
Country : US
Telephone Number : 818-894-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2024
Last Update Date : 05/13/2024

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Directions to “ DASON DOMINGUEZ DPT” Practice Location

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