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Michelle Mae Domingo
Medical Physician Assistant in South Gate, California
NPI 1457660391

Michelle Mae Domingo is a Medical Physician Assistant based in South Gate, CA and is specialized in Medical. Michelle Mae Domingo practices in South Gate, CA. The NPI Number for Michelle Mae Domingo is 1457660391 and holds a License No. 52600 (California).

The current practice location address for Michelle Mae Domingo is 4075 Tweedy Blvd, South Gate, CA and can be reached out via phone at 323-566-4111.

Location: 4075 Tweedy Blvd, South Gate, CA, 90280-6146
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1457660391
Provider Name
Michelle Mae Domingo
Credential
Provider Entity Type
Individual
Gender
Female
Address
4075 Tweedy Blvd, South Gate, CA, 90280-6146
Phone Number
323-566-4111
Fax Number
Provider Enumeration Date
09/27/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4075 Tweedy Blvd
City
South Gate
State
California
Zip
90280-6146
Phone Number
323-566-4111
Fax Number
person
Provider Business Mailing Address Details
Address
4075 Tweedy Blvd
City
South Gate
State
California
Zip
90280-6146
Phone Number
323-566-4111
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
52600 (California)
Definition
Definition to come...
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