Abigail Ann Constantino Domingo, NP

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

95028754 Issued in CA

Practice address

3451 W Century Blvd Ste B1
Inglewood, CA 90303-1228

Phone

(310) 677-9400

NPI assigned

Jun 4, 2024

Sex

Female

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

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1609617786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3451 W CENTURY BLVD STE B1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903031228",
            "telephone_number": "310-677-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 W CENTURY BLVD STE B1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903031228",
            "telephone_number": "310-677-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "ABIGAIL ANN",
        "middle_name": "CONSTANTINO",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "95028754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divine Solutions Alliance
• Michelle Sherron Dixon
• Tamara L Dixon, D.D.S.
• Doctor Paul Memorial Medical Center
• Eve D Domacena
• Jacqueline Dominguez
• Domtek Medical&Allied Services Inc
• Frances Donison
• Doris a. Guevara D.D.S., Inc
• Michael Dounel, D.M.D.

• Internal Medicine Physician in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.