UNTIED STATES NAVY


Address: Bldg 620305 8th Street, Camp Pendelton, CA 92055
Phone: 9519929627

UNTIED STATES NAVY (NPI# 1477940039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477940039
Entity Type Organization
Organization Name UNTIED STATES NAVY
Practice Address Bldg 620305 8th Street
Camp Pendelton
CA 92055
Practice Telephone 9519929627
Mailing Telephone 9519929627
Enumeration Date 2015-04-22
Last Update Date 2015-04-22
Authorized Official Name MR. JERRED ALLEN LEE (IDC)
Authorized Official Telephone 9519929627
Authorized Official Credential IDC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1002X Military Health Care Provider
Specialization: Independent Duty Corpsman
Other Service Providers

Office Location

Street Address BLDG 620305 8TH STREET
City CAMP PENDELTON
State CA
Zip Code 92055

Providers in the same zip code

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 Information

Taxonomy Code 1710I1002X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Corpsman

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1528397072 Donald Dadson Delpilar Military Health Care Provider Clb-1 Headquarters Company, Box 555737, Camp Pendelton, CA 92055 2009-12-11

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1316547227 Landri Acosta Military Health Care Provider 5075 Tranquil Way # 102, Oceanside, CA 92057-7870 2020-10-29
1649879537 David Michael Soliani Military Health Care Provider Bld 4101 Stuart Mesa Road, Camp Pendleton, CA 92055-5584 2020-10-21
1801494182 Luis Alberto Necoechea Military Health Care Provider 1st Recon Bn Bas, Oceanside, CA 92055 2020-10-09
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
1356955918 Daniel Carr Military Health Care Provider 5423 Lake Murray Blvd Apt 7, La Mesa, CA 91942-1551 2020-09-01
1255945069 Jeremy Lee Military Health Care Provider 509 Dennery Rd Apt 145, San Diego, CA 92154-8542 2020-08-31
1639782899 Tyler Collin Sparks Military Health Care Provider 1 Mrb, Camp Pendletion, CA 92055 2020-08-27
1013520667 Rashaad Brown Military Health Care Provider 4454 Cherokee Ave Apt 2, San Diego, CA 92116-3611 2020-08-24
Find all providers with the same taxonomy

Competitor

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City CAMP PENDELTON
Zip Code 92055

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Dataset Information

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.

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