Active NPI
Derek Dominguez, PHARM.D, RPH.
- Pharmacist
- Long Beach, CA
National Provider Identifier
1144673393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 68824
- Practice address
- 3553 Atlantic Ave Ste a
Long Beach, CA 90807-5605 - Phone
- (562) 427-5577
- NPI assigned
- Jul 22, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 68824 | CA | Primary |
Addresses
Primary practice location
3553 Atlantic Ave Ste a
Long Beach, CA 90807-5605
Mailing address
22226 Anthony Dr
Lake Forest, CA 92630-2327
Phone (949) 439-3528
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
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68824 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469145600000",
"number": "1144673393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22226 ANTHONY DR",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926302327",
"telephone_number": "949-439-3528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3553 ATLANTIC AVE STE A",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908075605",
"telephone_number": "562-427-5577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "DEREK",
"name_prefix": "Dr.",
"credential": "PHARM.D, RPH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-22",
"last_updated": "2016-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "68824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.