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1578952636
GUSTAVO DOMINGUEZ
COMMERCE, CA
NPI
1578952636
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2015-01-13
Last Update Date
2015-01-13
Business Address
-- GUSTAVO DOMINGUEZ
5425 POMONA BLVD
COMMERCE, CA 90022-1716
Phone number: 323-832-7527
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Mailing Address
-- GUSTAVO DOMINGUEZ
1019 ALBANY ST APT 3
LOS ANGELES, CA 90015-1246
Phone number: 213-663-3008
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