Domico, Michele B

Domico, Michele B is an individual health care provider with primary practice located at 455 S Main Street , Orange CA 92868-3835. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, which is considered as her primary health care specialty. Domico, Michele B can be contacted via phone (714) 532-8620.

Contact Information

Primary practice address
455 S Main Street Orange CA 92868-3835
Fax: (714) 289-4072
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X A83525 California

Profile Details

NPI number 1932305000
LBN Legal business name Domico, Michele B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932305000 NPPES
California MEDICAID 00A835250

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