| Susan Dominic, M.d., Inc. | |
|
7780 N Fresno St Suite 100 Fresno CA 93720-2413 | |
| (559) 493-5760 | |
| (559) 493-5292 |
| Full Name | Susan Dominic, M.d., Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 7780 N Fresno St, Fresno, California |
| Authorized Official Name and Position | Susan Renee Dominic (OWNER/PHYSICIAN) |
| Authorized Official Contact | 5592464497 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Dominic, M.d., Inc. 7780 N Fresno St Suite 100 Fresno CA 93720-2413 Ph: (559) 493-5760 | Susan Dominic, M.d., Inc. 7780 N Fresno St Suite 100 Fresno CA 93720-2413 Ph: (559) 493-5760 |
| NPI Number | 1073931697 |
|---|---|
| Provider Enumeration Date | 04/01/2014 |
| Last Update Date | 04/01/2014 |
| Medicare PECOS PAC ID | 8325271422 |
|---|---|
| Medicare Enrollment ID | O20140424002241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073931697 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G68190 (California) | Primary |
| Provider Name | Susan R Dominic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285742312 PECOS PAC ID: 3577626001 Enrollment ID: I20090109000532 |
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