Healthcare Provider Details

I. General information

NPI: 1447516398
Provider Name (Legal Business Name): DOMINIC DI TOMASSO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E 7TH ST
LONG BEACH CA
90822-5201
US

IV. Provider business mailing address

1505 4TH ST APT 201
SAN FRANCISCO CA
94158-2268
US

V. Phone/Fax

Practice location:
  • Phone: 562-826-8000
  • Fax:
Mailing address:
  • Phone: 925-285-1855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA128668
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: