Tina L R Dominguez, PA-C, MMS is a
Physician Assistant physician based in San Ramon, California. Tina L R Dominguez is licensed to practice in California (license number PA21463) and her current practice location is 2305 Camino Ramon Ste 225, San Ramon, California. She can be reached at her office (for appointments etc.) via phone at
(253) 471-4509.
NPI number for Tina L R Dominguez is 1922305671 and her current mailing address is 525 Olympic Ave, Hayward, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1922305671.
Physician's Profile
| Full Name | Tina L R Dominguez |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 2305 Camino Ramon Ste 225, San Ramon, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1922305671
- Provider Enumeration Date: 02/15/2011
- Last Update Date: 03/06/2020
Medical Identifiers
Medical identifiers for Tina L R Dominguez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1922305671 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207KA0200X | Allergy & Immunology - Allergy | PA21463 (California) | Secondary |
| 363A00000X | Physician Assistant | PA21463 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tina L R Dominguez is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tina L R Dominguez, PA-C, MMS
525 Olympic Ave,
Hayward, CA 94544-6528
Ph: (650) 766-2923 | Tina L R Dominguez, PA-C, MMS
2305 Camino Ramon Ste 225,
San Ramon, CA 94583-1394
Ph: (253) 471-4509 |
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