Provider Demographics
NPI:1841647575
Name:DOMINE-FLORES, MA CORAZON SABADO (RN)
Entity type:Individual
Prefix:
First Name:MA CORAZON
Middle Name:SABADO
Last Name:DOMINE-FLORES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MA CORAZON
Other - Middle Name:SABADO
Other - Last Name:DOMINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:13884 EUCLID ST APT B01
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-3401
Mailing Address - Country:US
Mailing Address - Phone:707-953-2587
Mailing Address - Fax:
Practice Address - Street 1:13884 EUCLID ST APT B01
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-3401
Practice Address - Country:US
Practice Address - Phone:707-953-2587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA809480282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access