Active NPI
Antoinette Domingo, PT
- Physical Therapist
- San Diego, CA
National Provider Identifier
1659783553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501011514
- Practice address
- 5500 Campanile Dr
Ens
San Diego, CA 92182-7251 - Phone
- (619) 594-3289
- NPI assigned
- May 27, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501011514 | MI | Primary |
Addresses
Primary practice location
5500 Campanile Dr
Ens
San Diego, CA 92182-7251
Mailing address
5500 Campanile Dr
Ens
San Diego, CA 92182-7251
Phone (619) 594-3289
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 |
|---|---|---|---|
| 5501011514 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401148800000",
"number": "1659783553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5500 CAMPANILE DR",
"address_2": "ENS",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921827251",
"telephone_number": "619-594-3289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 CAMPANILE DR",
"address_2": "ENS",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921827251",
"telephone_number": "619-594-3289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGO",
"first_name": "ANTOINETTE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-27",
"last_updated": "2014-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501011514",
"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 May 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.