Dominguez Pharmacy LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY43987 Issued in CA

Legal business name

DOMINGUEZ PHARMACY LP

Practice address

2055 N Perris Blvd Ste A1
Perris, CA 92571-2515

Phone

(951) 943-8188

Fax

(951) 943-8199

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Andres Dominguez, PHARM D

Title

General Partner / Pic

Phone

(951) 943-8188

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• DOMINGUEZ PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1144302928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 E ARROW HWY",
            "address_2": "SUITE K",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865525",
            "telephone_number": "909-981-1009",
            "fax_number": "909-981-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 N PERRIS BLVD STE A1",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925712515",
            "telephone_number": "951-943-8188",
            "fax_number": "951-943-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINGUEZ PHARMACY LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_title_or_position": "GENERAL PARTNER / PIC",
        "authorized_official_telephone_number": "951-943-8188",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY43987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144302928",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0503943",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOMINGUEZ PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vishal R Dhuliya, DDS
• Kymberly Diaz
• Rodrigo Diaz
• Jessica Renee Digiorno
• Divine Global LLC
• Andres E Dominguez, PHARM D
• Melina Belen Dominguez
• Dr Dorys P Vargas Optometrist Inc
• Dr Robert Bruce Reid Perris Family Care Center
• Dr. Javier Rios a Medical Corporation

• Community/Retail Pharmacy in Perris, CA
• Providers in Perris, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.