Ethan Dominguez
Ethan Dominguez is a Community Health Worker in Culver City, California. Practices as a sole proprietor. Registered with an NPI since 2023.
- In the registry since
- 2023
Practice location Address checks out
9808 Venice Blvd Ste 700Culver City, CA 90232-6824
Phone: (310) 945-3350
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Specialties & licences
| Community Health Worker (primary) | Taxonomy 172V00000X |
|---|
Record details
| NPI number | 1073213930 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | March 8, 2023 |
| Last updated in NPPES | March 8, 2023 |
| Certification date | March 8, 2023 |
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