Provider Demographics
NPI:1124189972
Name:DOMINGUEZ, ARTHUR MARTIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:MARTIN
Last Name:DOMINGUEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 BALDWIN PARK BLVD
Mailing Address - Street 2:PHARMACY OPERATIONS 5TH FLOOR
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-5806
Mailing Address - Country:US
Mailing Address - Phone:626-851-5073
Mailing Address - Fax:626-851-5813
Practice Address - Street 1:1011 BALDWIN PARK BLVD
Practice Address - Street 2:PHARMACY OPERATIONS 5TH FLOOR
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-5806
Practice Address - Country:US
Practice Address - Phone:626-851-5073
Practice Address - Fax:626-851-5813
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH38775183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH 38775OtherREGISTERED PHARMACIST