Provider Demographics
NPI:1659610046
Name:DUMAGUIN, EDMUND PEREZ (RN,BSN)
Entity Type:Individual
Prefix:MR
First Name:EDMUND
Middle Name:PEREZ
Last Name:DUMAGUIN
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 1:120 HOLCOMB LN
Mailing Address - Street 2:
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-1206
Mailing Address - Country:US
Mailing Address - Phone:707-554-8251
Mailing Address - Fax:
Practice Address - Street 1:120 HOLCOMB LN
Practice Address - Street 2:
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-1206
Practice Address - Country:US
Practice Address - Phone:707-554-8251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA540111163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency