NPIMap

Organization Active NPI

Miguel Dominguez MD, a Professional Corporation

  • Non-Pharmacy Dispensing Site
  • Tustin, CA
National Provider Identifier
1639444292
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
MIGUEL DOMINGUEZ MD, A PROFESSIONAL CORPORATION
Practice address
18102 Irvine Blvd
Ste 208
Tustin, CA 92780-3402
Phone
(714) 371-9000
NPI assigned
Mar 15, 2012
Last updated
Mar 15, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
MIGUEL DOMINGUEZ MD, A PROFESSIONAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Authorized official

Name
Dr. Miguel Dominguez, M.D.NPI 1235170556
Title
Ceo
Phone
(714) 371-9000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

18102 Irvine Blvd
Ste 208
Tustin, CA 92780-3402

Mailing address

2980 N Beverly Glen Cir
Suite 301
Los Angeles, CA 90077-1726
Phone (310) 474-9809

National Provider Directory

National Provider Directory
Tax ID family
Miguel Dominguez MD a Professional Corporation3 organizations share this tax ID, including this one
Part of
Miguel Dominguez MD a Professional Corporation

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1639444292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-474-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18102 IRVINE BLVD",
            "address_2": "STE 208",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803402",
            "telephone_number": "714-371-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIGUEL DOMINGUEZ MD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIGUEL DOMINGUEZ MD, A PROFESSIONAL CORPORATION",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-371-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.