Active NPI
Marice Angelic Dominguez, RCP
- Pulmonary Function Technologist Registered Respiratory Therapist
- Imperial Beach, CA
National Provider Identifier
1013440502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Function Technologist Registered Respiratory Therapist
- License
- 32647
- Practice address
- 1021 Elder Ave
Imperial Beach, CA 91932 - Phone
- (619) 292-4042
- NPI assigned
- Apr 11, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Function Technologist Registered Respiratory Therapist | 2279P1006X | 32647 | CA | Primary |
Addresses
Primary practice location
1021 Elder Ave
Imperial Beach, CA 91932
Mailing address
1021 Elder Avenue
Imperial Beach, CA 91932
Phone (619) 292-4042
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32647 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491868800000",
"number": "1013440502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 ELDER AVENUE",
"city": "IMPERIAL BEACH",
"state": "CA",
"postal_code": "91932",
"telephone_number": "619-292-4042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1021 ELDER AVE",
"city": "IMPERIAL BEACH",
"state": "CA",
"postal_code": "91932",
"telephone_number": "619-292-4042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "MARICE",
"middle_name": "ANGELIC",
"name_prefix": "Mrs.",
"credential": "RCP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-11",
"last_updated": "2017-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "2279P1006X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Registered, Pulmonary Function Technologist",
"state": "CA",
"license": "32647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Imperial Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.