Organization Active NPI

Dominique Gia-Gia Doan a Professional Medical Corporation

  • Obstetrics & Gynecology Physician
  • San Gabriel, CA
National Provider Identifier
1144767534
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A38598 Issued in CA
Legal business name
DOMINIQUE GIA-GIA DOAN A PROFESSIONAL MEDICAL CORPORATION
Practice address
323 W Valley Blvd
San Gabriel, CA 91776-3726
Phone
(626) 300-0005
NPI assigned
Jan 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Authorized official

Name
Dominique DoanNPI 1043231632
Title
Owner
Phone
(626) 502-7890

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)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X A38598 CA Primary

Addresses

Primary practice location

323 W Valley Blvd
San Gabriel, CA 91776-3726

Mailing address

323 W Valley Blvd
San Gabriel, CA 91776-3726
Phone (626) 300-0005

Other identifiers 1

IdentifierTypeStateIssuer
1043231632MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170329001070 CA Part B Supplier - Clinic/Group Practice 5890070171 Receives reassigned benefits from 1 practitioner
Practice locations: San Gabriel, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0724278Dominique Doan323 West Valley, San Gabriel, CA 91776Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Locations

323 W Valley Blvd
San Gabriel, CA 91776
Phone (626) 300-0005

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1144767534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 W VALLEY BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763726",
            "telephone_number": "626-300-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 W VALLEY BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763726",
            "telephone_number": "626-300-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINIQUE GIA-GIA DOAN A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-24",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-502-7890"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A38598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043231632",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.