Doctor Name: | GUSTAVO DOMINGUEZ |
NPI Number: | 1578952636 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 5425 Pomona Blvd Commerce, CA - 900221716 |
Business Phone Number: | 3238327527 |
Business Fax Number: | 3238327599 |
Mailing Address: | 1019 Albany St Apt 3, LOS ANGELES |
State: | CA |
Postal Code: | 900151246 |
Phone Number: | 2136633008 |
Fax Number: | |
NPI Enumeration Date: | 01/13/2015 |
NPI Last Update Date: | 01/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171M00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Case Manager/Care Coordinator |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee |