DANNIE LYNN PERDOMO DO
NPI 1861997561
General Practice in San Diego, CA

Active since March 26, 2018PECOS EnrolledAccepts Medicare Assignment
3900 FIFTH AVE STE 110, SAN DIEGO, CA 92103(858) 554-1212 Get Directions Write a Review

NPPES record last updated: April 9, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 9, 2025, Jan 3, 2025, May 7, 2024 and 1 more (4 updates tracked since 2018).

About Dannie Lynn Perdomo Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DANNIE LYNN PERDOMO DO (NPI 1861997561) is an individual general practice provider in San Diego, California, licensed in California (23109) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS, maintains a secondary practice location in San Diego, and is a graduate of Lake Erie Col Of Osteo Med At Seton Hill Univ (2018).

NPPES Registry Identity

NPI1861997561
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameDANNIE LYNN PERDOMOCredential: DO
Location Address3900 FIFTH AVE STE 110San Diego, CA 92103-3122
Mailing Address3900 5th Ave Ste 110San Diego, CA 92103-3122 · (858) 554-1212
Sole ProprietorNo
Medical School CMSLake Erie Col Of Osteo Med At Seton Hill UnivGraduated 2018
Enumeration DateMarch 26, 2018
Last NPPES UpdateApril 9, 20254 updates tracked since enumeration
NPPES CertifiedApril 9, 2025
NPI 1861997561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Licenses Licensed in CA · 23109 Licensed in VA · 0102207353
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

3900 FIFTH AVE STE 110, San Diego, CA 92103

Secondary Practice Location 1

Location 16386 Alvarado Ct Ste 101San Diego, CA 92120-4906 · Phone (858) 900-9490 · Fax (858) 795-1195

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dannie Lynn Perdomo Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789066028
PECOS Enrollment IDI20240816001812
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
18 services13 patients

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Endocrinology, Diabetes & Metabolism)
3900 FIFTH AVE STE 110
SAN DIEGO, CA 92103
Nurse Practitioner
3900 FIFTH AVE STE 110
SAN DIEGO, CA 92103
Nurse Practitioner
3900 FIFTH AVE STE 110
SAN DIEGO, CA 92103
Family Medicine
3900 FIFTH AVE STE 110
SAN DIEGO, CA 92103
Dietitian, Registered
3900 FIFTH AVE STE 110
SAN DIEGO, CA 92103
Physician Assistant (Medical)
3900 FIFTH AVE STE 110
SAN DIEGO, CA 92103
Physician Assistant
3900 FIFTH AVE STE 110
SAN DIEGO, CA 92103
Family Medicine
3900 FIFTH AVE STE 110
SAN DIEGO, CA 92103

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1861997561, enumerated as an "individual" on March 26, 2018.

The provider is located at 3900 FIFTH AVE STE 110 SAN DIEGO, CA 92103 and the phone number is (858) 554-1212.

General Practice with taxonomy code 208D00000X.