Provider Demographics
NPI:1720044167
Name:DOMINGO, HONORATO GARCIA JR (ATC)
Entity Type:Individual
Prefix:MR
First Name:HONORATO
Middle Name:GARCIA
Last Name:DOMINGO
Suffix:JR
Gender:M
Credentials:ATC
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Mailing Address - Street 1:26222 REDLANDS BLVD
Mailing Address - Street 2:#28
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-7724
Mailing Address - Country:US
Mailing Address - Phone:909-335-5238
Mailing Address - Fax:909-335-5139
Practice Address - Street 1:1200 EAST COLTON AVE.
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-0999
Practice Address - Country:US
Practice Address - Phone:909-335-5238
Practice Address - Fax:909-748-6333
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer