Active NPI
Susan Dominic, M.D., Inc.
- Internal Medicine Physician
- Fresno, CA
National Provider Identifier
1073931697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G68190
- Legal business name
- SUSAN DOMINIC, M.D., INC.
- Practice address
- 7780 N Fresno St
Suite 100
Fresno, CA 93720-2413 - Phone
- (559) 493-5760
- Fax
- (559) 493-5292
- NPI assigned
- Apr 1, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Susan Renee Dominic, M.D.
- Title
- Owner/Physician
- Phone
- (559) 246-4497
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G68190 | CA | Primary |
Addresses
Primary practice location
7780 N Fresno St
Suite 100
Fresno, CA 93720-2413
Mailing address
7780 N Fresno St
Suite 100
Fresno, CA 93720-2413
Phone (559) 493-5760
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Susan Dominic MD
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Internal Medicine Physician
- Fresno, CA
- NPI 1205242153
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Fresno, CA
- NPI 1285742312
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396310400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1396310400000",
"number": "1073931697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7780 N FRESNO ST",
"address_2": "SUITE 100",
"city": "FRESNO",
"state": "CA",
"postal_code": "937202413",
"telephone_number": "559-493-5760",
"fax_number": "559-493-5292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7780 N FRESNO ST",
"address_2": "SUITE 100",
"city": "FRESNO",
"state": "CA",
"postal_code": "937202413",
"telephone_number": "559-493-5760",
"fax_number": "559-493-5292"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUSAN DOMINIC, M.D., INC.",
"organizational_subpart": "NO",
"enumeration_date": "2014-04-01",
"last_updated": "2014-04-01",
"status": "A",
"authorized_official_last_name": "DOMINIC",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "RENEE",
"authorized_official_title_or_position": "OWNER/PHYSICIAN",
"authorized_official_telephone_number": "559-246-4497",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "CA",
"license": "G68190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.