NAVAL MEDICAL CENTER SAN DIEGO (NPI# 1114330982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114330982 |
| Entity Type | Organization |
| Organization Name | NAVAL MEDICAL CENTER SAN DIEGO |
| Practice Address |
3609 Ocean Ranch Blvd Ste 110 Oceanside CA 92056-8601 |
| Mailing Address |
Naval Health Clinic Chraleston 110 Nnptc Cir Goose Creek SC 29445 |
| Practice Telephone | 7607540974 |
| Practice Fax Number | 7607251232 |
| Mailing Telephone | 7607540974 |
| Mailing Fax Number | 7607251232 |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2017-12-20 |
| Authorized Official Name | WILLIAM M CONDON (BUMED UBO) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL MEDICAL CENTER SAN DIEGO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2146145 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700245099 | Naval Medical Center San Diego | Pharmacy | Mcas Miramar Exchange Pharmacy, Bldg 2660, San Diego, CA 92126 | 2016-02-16 |
| 1265846323 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 34800 Bob Wilson Dr Ste 3, San Diego, CA 92134-1003 | 2014-06-17 |
| 1134569924 | Naval Medical Center San Diego | Substance Abuse Rehabilitation Facility | 500 Sylvester Rd, Bldg 500, San Diego, CA 92111 | 2013-06-26 |
| 1508036112 | Naval Medical Center San Diego | Military Hospital | 550 15th Street Unit 709, San Diego, CA 92101 | 2008-03-11 |
| 1982802179 | Naval Medical Center San Diego | Clinic/Center | 120 Town Center Pkwy, Santee, CA 92071-5801 | 2007-07-10 |
| 1205998101 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 34800 Bob Wilson Dr Ste 113, San Diego, CA 92134-1113 | 2006-12-15 |
| 1407927494 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 110 Bldg B Town Center Pkwy, Santee, CA 92134-1098 | 2006-11-13 |
| 1821197872 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | Bldg 601, San Diego, CA 92135 | 2006-09-22 |
| 1720187776 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 523 S 8th St, Bldg 523, El Centro, CA 92243 | 2006-09-22 |
| 1639278682 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | Bouganville Rd, Bldg 506, San Diego, CA 92155-0001 | 2006-09-22 |
| Street Address |
3609 OCEAN RANCH BLVD STE 110 |
| City | OCEANSIDE |
| State | CA |
| Zip Code | 92056-8601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306143441 | Margo Janeen Randolph | Counselor | 3609 Ocean Ranch Blvd Ste 110, Oceanside, CA 92056-8601 | 2011-02-25 |
| 1770003790 | Natalia Daniela Tamburini | Student in an Organized Health Care Education/Training Program | 3609 Ocean Ranch Blvd Ste 110, Oceanside, CA 92056-8601 | 2017-06-21 |
| 1912435249 | Jennifer De La Fuente | Student in an Organized Health Care Education/Training Program | 3609 Ocean Ranch Blvd Ste 110, Oceanside, CA 92056-8601 | 2017-05-31 |
| 1205386299 | Latoya Patterson | Case Manager/Care Coordinator | 3609 Ocean Ranch Blvd Ste 110, Oceanside, CA 92056-8601 | 2016-10-13 |
| 1750768990 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 3609 Ocean Ranch Blvd Ste 110, Oceanside, CA 92056-8601 | 2015-04-27 |
| 1063841500 | Ava Ree Riedesel | Counselor | 3609 Ocean Ranch Blvd Ste 110, Oceanside, CA 92056 | 2013-11-05 |
| 1962758615 | Serena Goldsmith | Counselor | 3609 Ocean Ranch Blvd Ste 110, Oceanside, CA 92056-8601 | 2012-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174148639 | Universal Health Net San Diego | Hospice Care, Community Based | 4155 Oceanside Blvd, Suite 240, Oceanside, CA 92056 | 2020-06-10 |
| 1750913216 | Jared Pomerenke | Counselor | 3923 Warning Rd., Suite D, Oceanside, CA 92056 | 2020-02-12 |
| 1700424728 | Donna Jean Trapolino | Dental Hygienist | Bldg414006 Nelson Rd, Camp Pendleton, CA 92056 | 2019-12-20 |
| 1679122717 | David King Ping | Registered Nurse | 3609 Ocean Ranch Blvd Street 104, Oceanside, CA 92056 | 2019-09-11 |
| 1396254058 | Alison Schurman | Nurse Practitioner | 200 Mercy Circle Dr, Department of Pediatrics, Oceanside, CA 92056 | 2017-09-26 |
| 1407212665 | Yolanda Orozco Gaeta | Marriage & Family Therapist | 3923 Waring Road Ste D, North Coastal Treatment Recovery Center, Oceanside, CA 92056 | 2016-01-04 |
| 1871982751 | Wael Wassef | Pharmacist | 4755 Oceanside Blvd Ste 130, Oceanside, CA 92056 | 2015-01-15 |
| 1639501869 | William Stacy Parks | Family Medicine | 2376 Back Nine St., Oceanside, CA 92056 | 2013-07-30 |
| 1760725766 | Great Expectations Services Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4825 Glenhaven Drive, Oceanside, CA 92056 | 2013-03-28 |
| 1649533993 | Justin Bowles | Family Medicine | 1761 Avenida Segovia, Oceanside, CA 92056 | 2012-06-21 |
| Find all providers in zip 92056 | ||||
| Taxonomy Code | 332000000X |
| Grouping | Suppliers |
| Classification | Military/U.S. Coast Guard Pharmacy |
| A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: new; 7/1/2006: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750768990 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 3609 Ocean Ranch Blvd Ste 110, Oceanside, CA 92056-8601 | 2015-04-27 |
| 1821485145 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 2122 S El Camino Real Ste 100, Oceanside, CA 92054-6209 | 2015-04-24 |
| 1760589527 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 3609 Ocean Ranch Blvd, Oceanside, CA 92056-2698 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952765125 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 135 Santa Margarita Rd, Camp Pendelton, CA 92055 | 2016-04-13 |
| 1821485152 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Hospital Camp Pendelton, 200 Mercy Circle, Camp Pendelton, CA 92055 | 2015-04-24 |
| 1275948143 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Basilone Road, Bldg 520450, Camp Pendleton, CA 92055 | 2014-06-30 |
| 1265846323 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 34800 Bob Wilson Dr Ste 3, San Diego, CA 92134-1003 | 2014-06-17 |
| 1285048348 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 41 Area Las Flores Nelson, Bldg 414006, Camp Pendleton, CA 92055 | 2014-06-17 |
| 1205249042 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 13 Area Branch Medic, Bldg 13129 14th St, Camp Pendelton, CA 92055 | 2014-06-10 |
| 1275946444 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Hq Regiment, 16th Street, Camp Pendelton, CA 92055 | 2014-06-05 |
| 1366855538 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Hq Reg 1 Mlg Ras, Bldg 14008, Camp Pendelton, CA 95008 | 2014-06-05 |
| 1841603248 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Branch Medical Clinic Naf, Bldg 23, El Centro, CA 92055 | 2014-06-04 |
| 1043622681 | David S Grant Medical Center | Military/U.S. Coast Guard Pharmacy | 461 Skymaster Cir Rm 149, Travis Afb, CA 94535-1909 | 2014-06-02 |
| Find all providers with the same taxonomy | ||||
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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.