Pennisi Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PENNISI MEDICAL GROUP

Practice address

1805 N California St Ste 406
Stockton, CA 95204-6033

Phone

(209) 227-7806

Fax

(209) 851-3853

NPI assigned

Dec 1, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Dominic Pennisi, MDNPI 1548703036

Title

Owner

Phone

(209) 227-7806

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dominic Pennisi, M.D.

  • Internal Medicine Physician
  • Lodi, CA
  • NPI 1548703036

  Multi-Specialty

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1043172760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST STE 406",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046033",
            "telephone_number": "209-227-7806",
            "fax_number": "209-851-3853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST STE 406",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046033",
            "telephone_number": "209-227-7806",
            "fax_number": "209-851-3853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNISI MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-01",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "PENNISI",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-227-7806",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cesar Pena
• Esmeralda J Pena
• Gabriella Rae Gonzales Pena
• Amber Pence
• Tasha Lynn Penkova, MS, CCC-SLP
• Vincent Pennisi, MD
• Vincent P Pennisi, M.D.
• Aleeza Rose Penny
• Cassandra Ariel Penny
• Marissa Penuelas

• Internal Medicine Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.