Active NPI
Lidia Domagalska
- Acupuncturist
- San Diego, CA
National Provider Identifier
1336600501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC17162
- Practice address
- 5703 Oberlin Dr Ste 308
San Diego, CA 92121-1743 - Phone
- (562) 308-0247
- NPI assigned
- Mar 28, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC17162 | CA | Primary |
Addresses
Primary practice location
5703 Oberlin Dr Ste 308
San Diego, CA 92121-1743
Mailing address
550 Front St Unit 2102
San Diego, CA 92101-7097
Phone (562) 308-0247
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC17162 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1336600501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 FRONT ST UNIT 2102",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921017097",
"telephone_number": "562-308-0247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5703 OBERLIN DR STE 308",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921211743",
"telephone_number": "562-308-0247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMAGALSKA",
"first_name": "LIDIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-28",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC17162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.