60TH MEDICAL GROUP (NPI# 1104925585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104925585 |
| Entity Type | Organization |
| Organization Name | 60TH MEDICAL GROUP |
| Practice Address |
101 Bodin Cir Travis Afb CA 94535-1809 |
| Mailing Address |
2569 Shorey Way Fairfield CA 94533-6562 |
| Practice Telephone | 7074233459 |
| Mailing Telephone | 7074236459 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2008-06-13 |
| Authorized Official Name | MARCOS LOPEZ (CLINICAL PHARMACIST) |
| Authorized Official Telephone | 7074233459 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 286500000X | Military Hospital | 4679 | PR | Hospitals |
| Street Address |
101 BODIN CIR |
| City | TRAVIS AFB |
| State | CA |
| Zip Code | 94535-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801893276 | Charles A Tujo | Radiology | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2005-06-30 |
| 1538769351 | Chelsey Violet Pelkey | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-10-30 |
| 1538768114 | Jordan Rose | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-10-23 |
| 1821606591 | Madelyn Hale | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-20 |
| 1932727856 | Julie Thein | Audiologist | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-07 |
| 1063039501 | Shae Daniel Bryant | Dentist | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-01 |
| 1598381089 | Aaron J Surbaugh | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-06-19 |
| 1194348466 | Amanda Vance | Registered Nurse | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-05-21 |
| 1427681196 | Bradley Burkey | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-02-20 |
| 1821629288 | Gloria Calvillo | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-02-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
| 1568081255 | Miguel Julian Moreno | Student in an Organized Health Care Education/Training Program | 690 Airmen Drive, Travis Afb, CA 94535 | 2020-04-13 |
| 1174096101 | Zlatoslava Karga | Nurse Practitioner | 60mdg / Sgow, 101 Bodin Circle, Travis Afb, CA 94535 | 2019-01-02 |
| 1437648292 | Luke C Vera | Dentist | David Grant Medical Center 101 Bodin Circle, Travis Air Force Base, CA 94535 | 2018-05-08 |
| 1588163430 | Sanaz Ziad | Pharmacist | 60mdg/mdts, 101 Bodin Circle, Travis Afb, CA 94535 | 2018-02-06 |
| 1194265686 | Geoffrey Johnston | Dentist | 60 Mdg/sgdd, 101 Bodin Circle, Travis Afb, CA 94535 | 2017-03-02 |
| 1336693407 | Hannah Isla Nordwall | Social Worker | 60 Mdg/mdos 101 Bodin Cir, Travis Afb, CA 94535 | 2016-08-06 |
| 1184177149 | Taylor Murrie-robinson | Social Worker | 60mdg / Sgow Mental Health Clinic, 101 Bodin Circle, Travis Afb, CA 94535 | 2016-07-26 |
| 1952759607 | Eric Kincaid-sharp | General Practice | 60 Mdg/amds, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-06-02 |
| 1023472040 | Genieve Marie Martinez-hernandez | Internal Medicine | 60 Mdg/sgomi, 101 Bodin Circle, Fairfield, CA 94535 | 2016-04-06 |
| Find all providers in zip 94535 | ||||
| Taxonomy Code | 286500000X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| A health care facility operated by the Department of Defense. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396125860 | Dfas | Military Hospital | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2015-05-31 |
| 1861639262 | Aaron O'neil Kibler | Military Hospital | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2009-01-07 |
| 1689608341 | David Grant Medical Center | Military Hospital | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508477258 | Micol Paul Zabala | Military Hospital | 3675 Lofberg St, San Diego, CA 92124-3221 | 2020-08-14 |
| 1801333992 | Us Navy | Military Hospital | 1752 Trellis Way, Chula Vista, CA 91915 | 2017-01-26 |
| 1245785179 | Va Medical Center | Military Hospital | 5939 Cedros Ave Apt A, Van Nuys, CA 91411-3104 | 2016-08-21 |
| 1831563535 | Dfas-cl/jflp | Military Hospital | Mpmd 01c, Box 555191, Camp Pendleton, CA 92055-5191 | 2015-11-18 |
| 1851707418 | Hand of Passion | Military Hospital | 2112 Century Park Ln Unit 218, Century City, CA 90067-3314 | 2014-07-03 |
| 1396156527 | Jonathan Kawi | Military Hospital | 8848 Corvus Pl, San Diego, CA 92126-1921 | 2014-05-09 |
| 1427302017 | Department of Va | Military Hospital | 1585 Trailwood Ave, Chula Vista, CA 91913-2994 | 2012-11-03 |
| 1790056372 | U. S. Navy | Military Hospital | 3423 Guadalcanal Rd, Bldg 401 2nd Deck, San Diego, CA 92155-5000 | 2012-01-13 |
| 1962770990 | Alma Irene Blackman | Military Hospital | 9119 Jamacha Rd, 149, Spring Valley, CA 91977-4162 | 2011-12-05 |
| 1841596301 | Va San Diego Healthcare System | Military Hospital | 4260 Porte De Palmas Unit 60, San Diego, CA 92122-5159 | 2011-02-01 |
| Find all providers with the same taxonomy | ||||
| City | TRAVIS AFB |
| Zip Code | 94535 |
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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.