ELLIOTT O MARTINEZ (NPI# 1871786335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871786335 |
Entity Type | Individual |
Full Name | ELLIOTT O MARTINEZ |
Credential | IDC |
Practice Address |
State Road 108 Bldg 3005 Dewert Branch Health Clinic Bridgeport CA 93517-7777 |
Mailing Address |
S.r. 108 Bldg 3005 Bridgeport CA 93517 |
Practice Telephone | 7609321616 |
Practice Fax Number | 7609321623 |
Mailing Telephone | 7609321616 |
Mailing Fax Number | 7609321623 |
Enumeration Date | 2007-08-19 |
Last Update Date | 2015-10-23 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
Street Address |
STATE ROAD 108 BLDG 3005 DEWERT BRANCH HEALTH CLINIC |
City | BRIDGEPORT |
State | CA |
Zip Code | 93517-7777 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861785651 | Greg Urick | Military Health Care Provider | Sr 108 Bldg 3005, Dewert Branch Medical Clinic, Bridgeport, CA 93517 | 2011-05-26 |
1093023681 | Robert Joseph Scherl | Physician Assistant | Bldg #3005 S.r. 108, Naval Hospital Branch Clinic, Bridgeport, Bridgeport, CA 93517 | 2010-09-17 |
1649416835 | Duane E Postler | Military Health Care Provider | Bldg 3005 Sr 108, Bridgeport, CA 93517 | 2008-12-18 |
1730339763 | Toby Natividad Hernandez | Military Health Care Provider | Mwtc Bldg 3005 State Route 108, Attn: Medical, Bridgeport, CA 93517 | 2008-09-26 |
1083817597 | Branch Medical Clinic Bridgeport | Clinic/Center | Mwtc Bldg 3005, Bridgeport, CA 93517 | 2007-06-11 |
1730205949 | County of Mono | Ambulance | 199 Twin Lakes Road, Bridgeport, CA 93517 | 2007-03-21 |
1720134372 | Tommy Savedra | Physician Assistant | 221 Twin Lakes Rd, Bridgeport, CA 93517 | 2007-01-26 |
1043383508 | Susan Flanigan Bates | Nurse Practitioner | Mcmwtc Bldg 3005, Hc 83 Box 1, Bridgeport, CA 93517 | 2006-11-15 |
1003885427 | Ryan Stephen Hildebrand | Military Health Care Provider | Bldg 3005, S R 108, Bridgeport, CA 93517 | 2006-03-16 |
1497735435 | Chris Joas | General Practice | Bldg 3005, Sr 108, Dewert Branch Health Clinic, Mcmwtc, Bridgeport, CA 93517 | 2006-01-17 |
Find all providers in zip 93517 |
Taxonomy Code | 1710I1002X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Specialization | Independent Duty Corpsman |
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] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861785651 | Greg Urick | Military Health Care Provider | Sr 108 Bldg 3005, Dewert Branch Medical Clinic, Bridgeport, CA 93517 | 2011-05-26 |
1649416835 | Duane E Postler | Military Health Care Provider | Bldg 3005 Sr 108, Bridgeport, CA 93517 | 2008-12-18 |
1730339763 | Toby Natividad Hernandez | Military Health Care Provider | Mwtc Bldg 3005 State Route 108, Attn: Medical, Bridgeport, CA 93517 | 2008-09-26 |
1477594646 | Michael Dale Richardson | Military Health Care Provider | Hc-83 Bldg 3005, Naval Hospital Branch Clinic Mcmwtc, Bridgeport, CA 93517-0001 | 2006-06-09 |
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 |
City | BRIDGEPORT |
Zip Code | 93517 |
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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.