Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michelle Mae Domingo

Individual provider Medical Physician Assistant · NPI 1457660391

Michelle Mae Domingo is a Physician Assistant in South Gate, California. Graduated from University of Southern California Keck School of Medicine in 2015, 11 years ago. Practices with Narciso M Azurin M D Inc, a 3-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
11
Trained at
University of Southern California Keck School of Medicine
Licensed in
CA
In the registry since
2010
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Practice location Address checks out

4075 Tweedy Blvd
South Gate, CA 90280-6146
Phone: (323) 566-4111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 52600 (CA)

Record details

NPI number1457660391
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 27, 2010
Last updated in NPPESJune 23, 2015
Mailing address4075 Tweedy Blvd, South Gate, CA 90280-6146

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Narciso M Azurin M D Inc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in South Gate