DR. ANDREW JAMES MEDENBACH (NPI# 1033560354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033560354 |
| Entity Type | Individual |
| Full Name | DR. ANDREW JAMES MEDENBACH |
| Credential | D.O. |
| Practice Address |
34800 Bob Wilson Drive Naval Med Center San Diego CA 92134 |
| Practice Telephone | 6195328547 |
| Mailing Telephone | 6195328547 |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2016-06-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | Other Service Providers |
| Street Address |
34800 BOB WILSON DRIVE NAVAL MED CENTER |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730167917 | Charles F Jackson | Audiologist | 34800 Bob Wilson Drive, Naval Medical Center, San Diego, San Diego, CA 92134-5000 | 2006-01-06 |
| 1801406731 | Calvin Tyler Skinner | Dentist | 34800 Bob Wilson Drive, Building 2, Ground Floor/quality Management Suite, San Diego, CA 92134 | 2020-08-05 |
| 1245714476 | Rebekah Elaine Glennnorris | Social Worker | 34800 Bob Wilson Drive, Bldg 1, Floor 2, Suite 208, San Diego, CA 92134 | 2018-09-24 |
| 1942799440 | Jodi Watson | Midwife | 34800 Bob Wilson Drive, San Diego, CA 92134-5000 | 2018-05-09 |
| 1821585332 | Dejanae Hairston | Military Health Care Provider | 34800 Bob Wilson Drive, San Diego, CA 92134 | 2018-04-19 |
| 1124577911 | Lisa Tang | Student in an Organized Health Care Education/Training Program | 34800 Bob Wilson Drive, Naval Medical Ctr, San Diego, CA 92134-5000 | 2016-09-22 |
| 1891241451 | Sterling Thompson | Dentist | 34800 Bob Wilson Drive, Naval Medical Ctr, San Diego, CA 92134-5000 | 2016-09-01 |
| 1851845242 | Oanh Pham Hutson | Student in an Organized Health Care Education/Training Program | 34800 Bob Wilson Drive, Naval Medical Center San Diego, San Diego, CA 92134-5000 | 2016-08-15 |
| 1104277953 | Jaydeep Raval | Military Health Care Provider | 34800 Bob Wilson Drive, Al Medical Center, San Diego, CA 92134-5000 | 2016-06-23 |
| 1770947939 | William Christopher Dyer | Dentist | 34800 Bob Wilson Drive, Naval Medical Center San Diego, San Diego, CA 92134-5000 | 2016-04-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477178457 | Joseph Hunter Sampson | Military Health Care Provider | 34101 Farenholt Ave #14, San Diego, CA 92134 | 2020-06-15 |
| 1508495201 | Benjamin Michael Taylor | Military Health Care Provider | Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2020-04-04 |
| 1255870333 | Dosh Page | Physician Assistant | Swmi Farenholt Avenue, Building 14, San Diego, CA 92134 | 2017-02-22 |
| 1417328063 | Noem Clay Gallego | Military Health Care Provider | 34101 Building 14, Farenholt Avenue, San Diego, CA 92134 | 2015-10-08 |
| 1972999183 | Justin Paul Lachney | Military Health Care Provider | 34101 Farenholt Avenue, San Diego, CA 92134 | 2015-04-14 |
| 1174963532 | Ryan Anders Crane | Otolaryngology | Department of Otolaryngology - Nmc San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134 | 2013-07-01 |
| 1447591268 | Amy B. Cornell | Student in an Organized Health Care Education/Training Program | 34800 Bob Wilson Drive, San Diego, Ca, Apo, AA 92134 | 2013-03-04 |
| 1841562956 | Christopher Patrick Androski Jr. | Emergency Medical Technician, Basic | Naval Medical Center San Diego 38400 Bob Wilson Dr, San Diego, CA 92134 | 2012-02-04 |
| 1164717740 | Jason James Weiner | Internal Medicine | Dept of Internal Medicine, Division of Rheumatology, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2011-06-13 |
| 1225320237 | Kimberly Ann Thompson | Student in an Organized Health Care Education/Training Program | Navy Medical Center San Diego Gme Department, 34800 Bob Wilson Dr., San Diego, CA 92134 | 2011-05-09 |
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| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629692389 | Christopher Matey | Military Health Care Provider | 34800 Bob Wilson Dr Ste 110, San Diego, CA 92134-1110 | 2020-05-29 |
| 1982225769 | Jin Ah Kim | Military Health Care Provider | Naval Medical Center San Diego 38400 Bon Wilson Drive, San Diego, CA 92134-5000 | 2020-05-03 |
| 1508495201 | Benjamin Michael Taylor | Military Health Care Provider | Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2020-04-04 |
| 1588292858 | Korina Erin Sandoval | Military Health Care Provider | Naval Medical Center Drive 38400 Bob Wilson Dr, San Diego, CA 92134-5000 | 2020-03-31 |
| 1033746508 | Hannah Johnson | Military Health Care Provider | 34800 Bob Wilson Dr Ste 403, San Diego, CA 92134-1403 | 2020-03-25 |
| 1891336541 | Prana Hands Nonprofit | Military Health Care Provider | 2180 Garnet Ave Ste 3l, San Diego, CA 92109-3676 | 2019-10-03 |
| 1992366587 | Darion Pegues | Military Health Care Provider | 3530 Kelsey St, San Diego, CA 92124-3516 | 2019-06-24 |
| 1083275762 | Tyler Bradshaw Thompson | Military Health Care Provider | 34, Farenholt Ave, San Diego, CA 92134-0001 | 2019-06-24 |
| 1558924274 | Nathan Alley-byrd | Military Health Care Provider | Navy Medical Center San Diego 34800 Bob Wilson Drive, San Diego, CA 92134-0001 | 2019-04-18 |
| 1013570290 | Mckennan A Cook | Military Health Care Provider | Nmcsd 34800 Bob Wilson Drive, San Diego, CA 92134-3300 | 2019-04-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.