MR. GERARD BAGALSO (NPI# 1366908337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366908337 |
| Entity Type | Individual |
| Full Name | MR. GERARD BAGALSO |
| Credential | IDC |
| Practice Address |
10392 Hammerberg Cv San Diego CA 92124-3507 |
| Practice Telephone | 8588595181 |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2019-02-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
10392 HAMMERBERG CV |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92124-3507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780150334 | Paullette Michelle Rosette | Marriage & Family Therapist | 5421 Escarchosa Lane, San Diego, CA 92124 | 2018-10-22 |
| 1699253179 | Laura Lychelle Kime | Behavioral Analyst | 4256 Tambor Ct, San Diego, CA 92124 | 2018-08-06 |
| 1720506850 | Jonathan Jacobs | Military Health Care Provider | 3064 Taussig St, San Diego, CA 92124 | 2017-09-08 |
| 1568856235 | Alvin Nguyen | Student in an Organized Health Care Education/Training Program | 10872 Portobelo Dr., San Diego, CA 92124 | 2015-03-20 |
| 1346552064 | Jeffrey Thomas Gilbert | Military Health Care Provider | 3841 Colina Dorado Dr, Apartment G108, San Diego, CA 92124 | 2010-07-10 |
| 1023334158 | Billy L Fuson Jr. | Military Health Care Provider | 6656 Antigua Blvd, San Diego, CA 92124 | 2010-04-14 |
| 1386866473 | Ephraim J. Tabornal, Dds, Inc. | Dentist | 10850 Baroque Lane, Suite C, San Diego, CA 92124 | 2007-05-02 |
| 1538255245 | Lisa Anne Hazlewood-hunt | Psychologist | 11770 Bernardo Plaza Ct. Suite 260, San Diego, CA 92124 | 2006-10-04 |
| 1740393586 | Brian L Mcdonald | Physical Therapist | 5950 Santo Road, Suite D, San Diego, CA 92124 | 2006-08-16 |
| 1003820614 | Eileen Louise Holman | Social Worker | 6586 Ambrosia Drive, #5204, San Diego, CA 92124 | 2006-07-28 |
| Find all providers in zip 92124 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770180648 | Darius Lee Sean Woods | Military Health Care Provider | 6033 Sandy Shore Ct, San Diego, CA 92139-1014 | 2020-10-05 |
| 1174130744 | Daniel Carrera | Military Health Care Provider | 2645 W Canyon Ave Apt 450, San Diego, CA 92123-4700 | 2020-09-28 |
| 1316551740 | Kyle Bode Francis | Military Health Care Provider | 3149 Murray Ridge Rd, San Diego, CA 92123-2917 | 2020-09-02 |
| 1255945069 | Jeremy Lee | Military Health Care Provider | 509 Dennery Rd Apt 145, San Diego, CA 92154-8542 | 2020-08-31 |
| 1013520667 | Rashaad Brown | Military Health Care Provider | 4454 Cherokee Ave Apt 2, San Diego, CA 92116-3611 | 2020-08-24 |
| 1932711934 | Alvaro Daniel Macias | Military Health Care Provider | 8685 Rio San Diego Dr Apt 4344, San Diego, CA 92108-6560 | 2020-08-20 |
| 1689286189 | Charles Luke Morris | Military Health Care Provider | 1675 Beta Ct, San Diego, CA 92126-7060 | 2020-08-18 |
| 1255943635 | Stephon Peyton Frost | Military Health Care Provider | 2654 Mendonca Dr, San Diego, CA 92110-4263 | 2020-08-18 |
| 1184235871 | Jaden Sandi | Military Health Care Provider | Swmi Sfidc Bldg 14 34101 Farenholt Ave, San Diego, CA 92134-0001 | 2020-08-14 |
| 1477178457 | Joseph Hunter Sampson | Military Health Care Provider | 34101 Farenholt Ave #14, San Diego, CA 92134 | 2020-06-15 |
| Find all providers in SAN DIEGO | ||||
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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.