Provider Demographics
NPI:1093777971
Name:DOMINICCI, FRANCISCO CESAR (RN, BSN)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:CESAR
Last Name:DOMINICCI
Suffix:
Gender:M
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10820
Mailing Address - Street 2:
Mailing Address - City:FORT IRWIN
Mailing Address - State:CA
Mailing Address - Zip Code:92310-0820
Mailing Address - Country:US
Mailing Address - Phone:760-386-4079
Mailing Address - Fax:
Practice Address - Street 1:DR. MARY WALKER CLINIC
Practice Address - Street 2:BLDG 170 ROOM 412
Practice Address - City:FORT IRWIN
Practice Address - State:CA
Practice Address - Zip Code:92310
Practice Address - Country:US
Practice Address - Phone:760-380-5414
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX648787163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX648787OtherRN