Active NPI
Andres E Dominguez, PHARM D
- Pharmacist
- Perris, CA
National Provider Identifier
1972692051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH36435
- Practice address
- 2055 N Perris Blvd
Suite A1
Perris, CA 92571 - Phone
- (951) 943-8188
- Fax
- (951) 943-8199
- NPI assigned
- Oct 12, 2006
- Last updated
- Feb 11, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH36435 | CA | Primary |
Addresses
Primary practice location
2055 N Perris Blvd
Suite A1
Perris, CA 92571
Mailing address
2055 N Perris Blvd
Suite A1
Perris, CA 92571
Phone (951) 943-8188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RPH36435 | Other | CA | CA STATE BOARD OF PHCY |
Other names 1
- Dr. Andres E Dominguez
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH36435 | CA | MD | Pharmacist |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Dominguez Pharmacy
- Community/Retail Pharmacy
- Lake Elsinore, CA
- NPI 1336373646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202688000000",
"number": "1972692051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2055 N PERRIS BLVD",
"address_2": "SUITE A1",
"city": "PERRIS",
"state": "CA",
"postal_code": "92571",
"telephone_number": "951-943-8188",
"fax_number": "951-943-8199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2055 N PERRIS BLVD",
"address_2": "SUITE A1",
"city": "PERRIS",
"state": "CA",
"postal_code": "92571",
"telephone_number": "951-943-8188",
"fax_number": "951-943-8199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "ANDRES",
"middle_name": "E",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2008-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH36435",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA STATE BOARD OF PHCY",
"identifier": "RPH36435",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANDRES",
"last_name": "DOMINGUEZ",
"middle_name": "E",
"prefix": "DR.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Perris, CA
- Kymberly Diaz
- Rodrigo Diaz
- Jessica Renee Digiorno
- Divine Global LLC
- Dominguez Pharmacy LP (Dominguez Pharmacy)
- Melina Belen Dominguez
- Dr Dorys P Vargas Optometrist Inc
- Dr Robert Bruce Reid Perris Family Care Center
- Dr. Javier Rios a Medical Corporation (Mead Valley Clinica Medica Familiar)
- Dr. Quan & Associates Optometric Corp
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.