Mintalucci, Dominic J

Mintalucci, Dominic J is an individual health care provider with primary practice located at 1405 Montgomery Dr , Santa Rosa CA 95405-4557. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Hand Surgery. Allopathic & Osteopathic Physicians / Hand Surgery is his primary health care specialty. Mintalucci, Dominic J can be contacted via phone (707) 546-1922.

Contact Information

Primary practice address
1405 Montgomery Dr Santa Rosa CA 95405-4557
Phone: (707) 546-1922
Fax: (707) 546-1897
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X A126421 California
Allopathic & Osteopathic Physicians / Hand Surgery 207XS0106X A126421 California

Profile Details

NPI number 1114126869
LBN Legal business name Mintalucci, Dominic J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2007
Last updated Oct 4th, 2013 - about 11 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 1114126869 NPPES
California Other A126421 LICENSE

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