National Provider Identifier Database

MARK RYAN V DOMINGO
Medical Technologist


Contact Information

MARK RYAN V DOMINGO
33608 ORTEGA HWY SAN JUAN CAPISTRANO
SAN JUAN CAPISTRANO, CA92675
Phone: 800-642-4657
Fax:
Website:
Specialty Taxonomy Code
* Medical Technologist 246QM0706X

* Indicates primary specialty

NPI Profile & details for MARK RYAN V DOMINGO

NPI Number 1245084458
Credentials
Entity Individual
Enumeration date 04/15/2024
Last updated 04/15/2024 - About 2 years ago
Sole proprietor1 Yes
Identifiers
  • CA License #: MTA-02245121
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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