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1467726380
LANI DOMINGO ANTONIO
MODESTO, CA
NPI
1467726380
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA22113)
Enumeration Date
2012-02-24
Last Update Date
2013-11-25
Business Address
Mr. LANI DOMINGO ANTONIO PA
200 E HACKETT RD
MODESTO, CA 95358-9415
Phone number: 831-801-7110
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Mailing Address
Mr. LANI DOMINGO ANTONIO PA
200 E HACKETT RD
MODESTO, CA 95358-9415
Phone number: 831-801-7110
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