Dominguez, Charles E

Dominguez, Charles E is an individual health care provider with primary practice located at 21098 Bake Pkwy Suite 110, Lake Forest CA 92630-2163. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Dominguez, Charles E can be contacted via phone (949) 597-0104.

Contact Information

Primary practice address
21098 Bake Pkwy Suite 110 Lake Forest CA 92630-2163
Phone: (949) 597-0104
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT 12292 TPA California

Profile Details

NPI number 1063437507
LBN Legal business name Dominguez, Charles E
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated Oct 15th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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