Mr. LANI DOMINGO ANTONIO II PA
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1467726380- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PA
- Status
- Active
Contact & Location
- Address
- 200 E HACKETT RD, MODESTO, CA, 953589415
- Phone
- (831) 801-7110
Specialties & Taxonomies
Physician Assistant
Primary License: CA #PA22113