David Alan Dominguez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13224 Issued in CA

Practice address

101 Bodin Circle
David Grant Medical Center
Travis AFB, CA 94535-1800

Phone

(707) 423-7611

Fax

(707) 423-3260

NPI assigned

Oct 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356422521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 W WINTON AVE",
            "address_2": "BLDG. # 9",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945451310",
            "telephone_number": "510-750-3157",
            "fax_number": "510-293-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIRCLE",
            "address_2": "DAVID GRANT MEDICAL CENTER",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351800",
            "telephone_number": "707-423-7611",
            "fax_number": "707-423-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Andrew Dixon, LCSW
• James Daryl Dizmang, M.D.
• Vishal S Doctor, MD
• Kevin Dewayne Dodd Jr., IDMT
• Vincent Antonio Doll, PA-C
• James Joseph Doyle, M.D.
• Matthew Alan Duggan, PA-C
• Samuel Iwaguma Dunham, MD
• Stella Duong-Callahan
• Alane Denise Durand, O.D.

• Physician Assistant in Travis AFB, CA
• Providers in Travis AFB, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.