NAVAL MEDICAL CENTER SAN DIEGO (NPI# 1417197591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417197591 |
| Entity Type | Organization |
| Organization Name | NAVAL MEDICAL CENTER SAN DIEGO |
| Other Organization Name | US NAVY |
| Practice Address |
2446 Trident Way San Diego CA 92155-5494 |
| Practice Telephone | 6194370777 |
| Practice Fax Number | 6194375248 |
| Mailing Telephone | 6194370777 |
| Mailing Fax Number | 6194375248 |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2009-03-02 |
| Authorized Official Name | MR. RANDY N LIGHTCAP (PROVIDER) |
| Authorized Official Telephone | 6194370777 |
| Authorized Official Credential | IDC |
| Is Organization Subpart | Y |
| Parent Organization Name | US NAVY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| US NAVY | Other Name - Individual/Organization |
| 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 |
2446 TRIDENT WAY |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92155-5494 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235114034 | Melissa Dee Hiller | Psychologist | 2446 Trident Way, San Diego, CA 92155-5494 | 2005-12-14 |
| 1619372422 | Natashia Libby | Military Health Care Provider | 2446 Trident Way, San Diego, CA 92155-5494 | 2014-10-23 |
| 1548232697 | Rafael Perez Jr. | Physician Assistant | 2446 Trident Way, San Diego, CA 92155-5494 | 2006-02-03 |
| 1427029370 | Michael David Rosenthal | Specialist | 2446 Trident Way, San Diego, CA 92155-5494 | 2006-01-30 |
| 1598736449 | Michael Tad Garritson | Military Health Care Provider | 2446 Trident Way, Medical Clinic, San Diego, CA 92155-5494 | 2006-01-30 |
| 1790756641 | Edward J Biggs | Military Health Care Provider | 2446 Trident Way, Medical Department Nswc, San Diego, CA 92155-5449 | 2006-01-30 |
| 1497726525 | Mario Oswaldo Martin | Military Health Care Provider | 2446 Trident Way, San Diego, CA 92155-5494 | 2006-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134454770 | Carrie Lynn Decker | Military Health Care Provider | Eod Exp Support Unit One, 3502 Attu Rd Bldg 326 San Diego Ca, Apo, AA 92155 | 2009-10-15 |
| 1578779559 | Joe Leonard Bonvie | Psychologist | Naval Special Warfare Command, Medical Dept Code 04, 2000 Trident Way, San Diego, CA 92155 | 2007-05-15 |
| 1003840653 | Robert David Gerardi | Military Health Care Provider | 2841 Rendova Road, San Diego, CA 92155 | 2006-07-10 |
| 1346597234 | Jermy Joe Brower | Military Health Care Provider | Seal Team One 2534 Trident Way Bldg 614, San Diego, CA 92155-0001 | 2012-08-09 |
| 1720376684 | Brittany A Hout | Physician Assistant | Anaconda Rd Bldg 262, San Diego, CA 92155-0001 | 2011-07-13 |
| 1639278682 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | Bouganville Rd, Bldg 506, San Diego, CA 92155-0001 | 2006-09-22 |
| 1902393176 | Benjamin Alexander Sebreros | Student in an Organized Health Care Education/Training Program | 2446 Trident Way Bldg 637, San Diego, CA 92155-0001 | 2018-04-13 |
| 1790056372 | U. S. Navy | Military Hospital | 3423 Guadalcanal Rd, Bldg 401 2nd Deck, San Diego, CA 92155-5000 | 2012-01-13 |
| 1366592248 | Robert Ray Lowe Jr. | Emergency Medicine | 3400 Tarawa Rd, San Diego, CA 92155-5002 | 2007-01-11 |
| 1801868633 | Michael Griffin Swanson | Family Medicine | Naval Special Warfare Group Three, 3400 Tarawa Road Bldg.19, San Diego, CA 92155-5002 | 2006-02-06 |
| Find all providers in zip 92155 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1871023515 | Abi P&o Inc | Clinic/Center | 6190 Fairmount Ave Ste A, San Diego, CA 92120-3428 | 2017-06-15 |
| 1548705908 | Free Flow Health Acupuncture | Clinic/Center | 4002 Park Blvd. Ste.e, San Diego, CA 92103 | 2016-12-21 |
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| 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.