NAVAL HOSPITAL CAMP PENDLETON (NPI# 1467551424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467551424 |
| Entity Type | Organization |
| Organization Name | NAVAL HOSPITAL CAMP PENDLETON |
| Other Organization Name | CAMP PEND 31 ABC PHCY |
| Practice Address |
Stuart Mesa Rd Bldg 310514 Camp Pendleton CA 92055 |
| Mailing Address |
Po Box 555191 Camp Pendleton CA 92055-5191 |
| Practice Telephone | 7607257351 |
| Mailing Telephone | 7607251621 |
| Mailing Fax Number | 7607251661 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2018-05-25 |
| Authorized Official Name | MR. WILLIAM MICHAEL CONDON (NAVY MEDICINE UBO PROGRAM MANAGER) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HOSPITAL CAMP PENDLETON |
| 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 | 2115712 | 01 |
| Other Name | Type Code |
|---|---|
| CAMP PEND 31 ABC PHCY | Doing Business As Name - Organization |
| 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 |
| 1942697685 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Marine Corps Air Station, Bldg 1175, Yuma, AZ 85369 | 2015-04-21 |
| 1790179455 | Naval Hospital Camp Pendleton | Clinic/Center | 41 Area Branch Medical Clinic, Bldg 414006, Camp Pendleton, CA 92055 | 2015-03-20 |
| 1275948143 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Basilone Road, Bldg 520450, Camp Pendleton, CA 92055 | 2014-06-30 |
| 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 |
| 1972916740 | Naval Hospital Camp Pendleton | Pharmacy | 52 Area Branch Medical, 540450 Basilone Rd, Camp Pendelton, CA 92055 | 2014-06-09 |
| 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 |
| Street Address |
STUART MESA RD BLDG 310514 |
| City | CAMP PENDLETON |
| State | CA |
| Zip Code | 92055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598179905 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Stuart Mesa Rd, Bldg 310514, Camp Pendleton, CA 92055 | 2014-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730755 | Zaccary Griffin | Military Health Care Provider | Building 4101 Stuart Mesa Rd, Camp Pendleton, CA 92055 | 2020-11-02 |
| 1194325597 | Connie Lim Good | Dental Hygienist | 14th Street Bldg 13128, Oceanside, CA 92055 | 2020-10-27 |
| 1386243327 | Leticia Isabel Alcantar | Dental Hygienist | Bldg 520448, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1548869571 | Joshua Watersjackson | Specialist/Technologist | 430406 Las Pulgas, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1235737164 | Tynesha Felice Calimquim | Dental Hygienist | Naval Hospital Camp Pendleton, Dental Department, 200 Mercy Circle, Oceanside, CA 92055 | 2020-10-13 |
| 1801494182 | Luis Alberto Necoechea | Military Health Care Provider | 1st Recon Bn Bas, Oceanside, CA 92055 | 2020-10-09 |
| 1689271603 | Lorena Santodomingo | Dental Hygienist | Bldg 210735 C Street, Camp Pendleton, CA 92055 | 2020-10-02 |
| 1720695984 | Douglas Thomas Duncan | Dental Assistant | 92055- 14th Strret, Oceanside, CA 92055 | 2020-09-30 |
| 1528675980 | Dora Louise Young | Dental Assistant | 92055 14th Street, Camp Pendleton, CA 92055 | 2020-09-29 |
| 1306453956 | Lynne Marie Reardon | Dental Hygienist | Bldg 310515, Camp Pendleton, CA 92055 | 2020-09-28 |
| Find all providers in zip 92055 | ||||
| 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 |
|---|---|---|---|---|
| 1275948143 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Basilone Road, Bldg 520450, Camp Pendleton, CA 92055 | 2014-06-30 |
| 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 |
| 1356440317 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 14th Street, Bldg 13129, Camp Pendleton, CA 92055-5191 | 2006-09-22 |
| 1376642330 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Basiline Rd, Bldg 520450, Camp Pendleton, CA 92055 | 2006-09-22 |
| 1801995865 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Imhoff Road, Bldg 210735, Camp Pendleton, CA 92055 | 2006-09-22 |
| 1194824144 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 533020 Basilone Road, 53 Area Camp Horno, Camp Pendleton, CA 92055 | 2006-09-22 |
| 1053410019 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Basilone Rd Bldg 620305, Camp Pendleton, CA 92055 | 2006-09-22 |
| 1386743334 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Bldg 434057 Del Valle St, 43 Area Las Pulgas, Camp Pendleton, CA 92055 | 2006-09-22 |
| 1992804959 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 22 Area Branch Medical Clinic, Bldg 22190, Camp Pendleton, CA 92055 | 2006-09-22 |
| 1932208980 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 41 Area Las Flores Nelson Street, Bldg 414006, Camp Pendleton, CA 92055 | 2006-09-22 |
| Find all providers in CAMP PENDLETON | ||||
| City | CAMP PENDLETON |
| Zip Code | 92055 |
Please comment or provide details below to improve the information on NAVAL HOSPITAL CAMP PENDLETON.
| 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.