Search › California › 172A00000X
Ivan Dominguez
NPI 1629814116 · on the registry since 2024 · sole proprietor
Practice
- Address
- 824 Mount Ranier Way
El Dorado Hills, CA 95762 - Phone
- (818) 519-3699
- Organisation at this address
- Golden Age Transportation Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 172A00000X
172A00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-07-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California