NAVAL MEDICAL CENTER SAN DIEGO (NPI# 1396732871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396732871 |
| Entity Type | Organization |
| Organization Name | NAVAL MEDICAL CENTER SAN DIEGO |
| Practice Address |
34800 Bob Wilson Dr San Diego CA 92134-1098 |
| Practice Telephone | 6195326397 |
| Practice Fax Number | 6195326645 |
| Mailing Telephone | 6195326397 |
| Mailing Fax Number | 6195326645 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2019-04-04 |
| Authorized Official Name | MR. WILLIAM MICHAEL CONDON (NAVY MEDICINE UBO PROGRAM MANAGER) |
| 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 | 2865M2000X |
Military Hospital Specialization: Military General Acute Care Hospital |
Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DEA | AN1348463 | 01 |
| CA | BS PIN UB92 | ZZZH3722Z | 01 |
| CA | NCPDP | 05-20862 | 01 |
| CA | BS PIN HCFA 1500 | 00DOD3000 | 01 |
| CA | HSP63228F | 05 | |
| CA | ZZT23228F | 05 |
| 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 |
34800 BOB WILSON DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92134-1098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245235134 | Willie S Chao | Dentist | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2005-06-16 |
| 1023625571 | Samantha Savite | Student in an Organized Health Care Education/Training Program | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-09-29 |
| 1588270326 | Angelina Yvette Harris | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-09-17 |
| 1275149296 | Alexa Werner | Physical Therapist | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-09-16 |
| 1376157164 | Toure Marlow Hinton | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-08-31 |
| 1316550106 | John K Housinga | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-08-31 |
| 1073126249 | Alfredo Carrillo | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-08-27 |
| 1326651647 | Daniel Adan Denge | Registered Nurse | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-08-26 |
| 1275146664 | Zachariah Jacob Charles Boydsnee | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-08-26 |
| 1245843820 | Nikole Lanchares | Dentist | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-08-25 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 92134 | ||||
| Taxonomy Code | 2865M2000X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| Specialization | Military General Acute Care Hospital |
| A Department of Defense (DoD) health care organization furnishing inpatient care 24 hours per day in "fixed" facilities, primarily for DoD beneficiaries. Entity is Defense Health Program (DHP) funded. A "fixed" facility is a non-temporary, non-deployed facility usually used for health care services. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes those services and institutional costs usually included in a Diagnosis Related Group as well as "pass-through" items. |
| Notes: [1/1/2005: title modified, definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649682154 | United States Navy | Military Hospital | Logistics Support Unit Onemedic, 2424 Redova Rd Bldg 156, San Diego, CA 92155-5401 | 2014-06-02 |
| 1578734729 | Va San Diego Healthcare System | Military Hospital | 3350 La Jolla Village Dr -mail Box 122, San Diego, CA 92161-0002 | 2008-03-17 |
| 1306901988 | Balboa Hospital | Military Hospital | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2006-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679824585 | United States Navy | Military Hospital | Bldg 14137, Camp Pendleton, CA 92055-5697 | 2012-10-02 |
| 1396047866 | United States Navy | Military Hospital | 5065 Sunburst St, Joshua Tree, CA 92252-1831 | 2010-12-03 |
| 1316112311 | Michelle Bautista | Military Hospital | 8707 Troy St Apt 105, Spring Valley, CA 91977-2503 | 2008-04-29 |
| 1760651772 | Lance Mandernack | Military Hospital | 3371 Glendale Blvd, #186, Los Angeles, CA 90039-1825 | 2008-02-22 |
| 1306919501 | Weed Army Community Hospital | Military Hospital | Inner Loop, Fort Irwin, CA 92310-5109 | 2006-11-16 |
| 1699726570 | Naval Hospital Twentynine Palms | Military Hospital | 1145 Sturgis Road, Twentynine Palms, CA 92278 | 2006-05-15 |
| 1417304445 | V.a. Long Beach Medical Center | Military Hospital | 5901 E 7th St, Long Beach, CA 90822-5201 | 2016-05-19 |
| 1023377868 | Va Hospital | Military Hospital | 2615 E Clinton Ave, Fresno, CA 93703-2223 | 2012-05-14 |
| 1013187566 | Uscg Airsta Sacramento | Military Hospital | 5342 Dudley Blvd, Mcclellan, CA 95652-1012 | 2008-03-11 |
| 1386604387 | Naval Hospital Camp Pendleton | Military Hospital | 200 Mercy Circle, Fin Mgmt Code 0814, Camp Pendleton, CA 92055-5191 | 2006-03-24 |
| 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.