MOISES VELASCO (NPI# 1639300197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639300197 |
| Entity Type | Individual |
| Full Name | MOISES VELASCO |
| Credential | IDMT |
| Practice Address |
412 Th Medical Group 30 Nightingale Rd. Edwards Afb CA 93524-0001 |
| Practice Telephone | 6612771130 |
| Mailing Telephone | 6612771130 |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2013-01-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| Street Address |
412 TH MEDICAL GROUP 30 NIGHTINGALE RD. |
| City | EDWARDS AFB |
| State | CA |
| Zip Code | 93524-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114540499 | Nathaniel George Brown | Student in an Organized Health Care Education/Training Program | 412th Medical Group 30 Nightingale Rd., Building #5525, Edwards Air Force Base, CA 93524 | 2020-05-21 |
| 1265852396 | Wesley John Fischer | Pharmacist | 30 Nightengale Road, Edwards U.S. Air Force Base Pharmacy, Edwards, CA 93524 | 2014-04-16 |
| 1659567493 | Kevin Ray Hooker | Social Worker | 30 Nightingale Road, 5513, Lancaster, CA 93524 | 2007-09-14 |
| 1336655943 | Keith Janda | Physician Assistant | 95th Medical Group 30 Nightingale Road Building 5525, Edwards Afb, CA 93524-0001 | 2017-12-19 |
| 1598286049 | Mackenzie Johnson Clevenger | Pharmacist | 412 Mdg 30 Nightingale Rd, Edwards Afb, CA 93524-0001 | 2017-07-05 |
| 1245751460 | Brandon John Potters | Military Health Care Provider | Air Test and Evaluation Squadron Nine Rd 187 Rd, Edwards Afb, CA 93524-0001 | 2017-06-28 |
| 1003266073 | Meshva Akwalia | Pediatrics | 412 Medical Group 30 Nightingale Rd Bldg 5525, Edwards Afb, CA 93524-0001 | 2016-06-20 |
| 1144613670 | Pang Ko | Dentist | 30 Nightingale Ave Building 5513, Edwards, CA 93524-0001 | 2015-03-09 |
| 1710293345 | Tonya Nicole Barry | Dentist | Bldg 3925, 31 Nightingale Rd, Edwards Afb, CA 93524-0001 | 2010-08-20 |
| 1265761340 | Shanda R. Marshall | Nurse Practitioner | 412 Th Medical Grouup, 30 Nightingale Road, Edwards, CA 93524-0001 | 2009-12-18 |
| Find all providers in zip 93524 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144454802 | William Robert Cole | Military Health Care Provider | 412 Mdg Edwards Afb Ca, Edwards Afb, CA 93524-0001 | 2009-05-11 |
| 1346869096 | Seth Heying | Military Health Care Provider | 55 N Wolfe Ave, Edwards Afb, CA 93524-6201 | 2020-04-13 |
| 1992150569 | Nicholas Charles Kern | Military Health Care Provider | 30 Nightingale Rd, Edwards Afb, CA 93524-0001 | 2016-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366051294 | Ryan Allan Arriaga | Military Health Care Provider | 1000 Allison Dr, Vacaville, CA 95687-4975 | 2020-07-27 |
| 1851917165 | Katelyn Renee Watson | Military Health Care Provider | 101 Bodin Drive, Bldg 777, Fairfield, CA 95688 | 2020-06-23 |
| 1558911024 | Christopher Andersen | Military Health Care Provider | 1000 Allison Dr Apt 183, Vacaville, CA 95687-4988 | 2019-09-17 |
| 1558873968 | Giovanni Oddo | Military Health Care Provider | 25051 Mawson Dr, Laguna Hills, CA 92653-5263 | 2017-10-26 |
| 1730606658 | Jeffrey Rodriguez | Military Health Care Provider | 975 Carl Cir, Edwards, CA 93523-1906 | 2017-08-23 |
| 1154847960 | James Edward Schafer | Military Health Care Provider | 883 Covey Ct, Hollister, CA 95023-8906 | 2017-08-15 |
| 1437551702 | Jonathan Saplan | Military Health Care Provider | 1411 Pelican Way, Suisun City, CA 94585-2330 | 2014-09-18 |
| 1093124398 | Benjamin Ryan Foy | Military Health Care Provider | 2784 Hornet Way, San Diego, CA 92106-6421 | 2014-08-12 |
| 1598182214 | Matthew Wheaton Burns | Military Health Care Provider | 105 Colorado St, Travis Afb, CA 94535-1255 | 2014-03-19 |
| 1508282658 | April Summers | Military Health Care Provider | 2205 Farrell Ave Apt 204, Redondo Beach, CA 90278-1846 | 2014-03-13 |
| Find all providers with the same taxonomy | ||||
| City | EDWARDS AFB |
| Zip Code | 93524 |
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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.