BRANCH MEDICAL CLINIC AREA 62


Address: Bldg 620306 8th Street, Camp Pendleton, CA 92055
Phone: 7607257100

BRANCH MEDICAL CLINIC AREA 62 (NPI# 1871832394) 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) 1871832394
Entity Type Organization
Organization Name BRANCH MEDICAL CLINIC AREA 62
Other Organization Name 62MCMH AREA SAN MATEO 6225
Practice Address Bldg 620306 8th Street
Camp Pendleton
CA 92055
Practice Telephone 7607257100
Mailing Telephone 7607257100
Enumeration Date 2013-02-04
Last Update Date 2018-05-25
Authorized Official Name WILLIAM M CONDON (BUMED UBO)
Authorized Official Telephone 2404013643
Is Organization Subpart Y
Parent Organization Name NAVAL HOSPITAL CAMP PENDLETON

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM1100X Clinic/Center
Specialization: Military/U.S. Coast Guard Outpatient
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
62MCMH AREA SAN MATEO 6225 Other Name - Individual/Organization

Office Location

Street Address BLDG 620306 8TH STREET
City CAMP PENDLETON
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 261QM1100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Military/U.S. Coast Guard Outpatient

Taxonomy Definition

The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.
Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154715803 Branch Medical Clinic Area 33 Clinic/Center 33 Area Branch Medical Clinic, Bldg 330305, Camp Pendleton, CA 92055 2015-03-20
1790179455 Naval Hospital Camp Pendleton Clinic/Center 41 Area Branch Medical Clinic, Bldg 414006, Camp Pendleton, CA 92055 2015-03-20
1245624907 Branch Medical Clinic Area 43 Clinic/Center 43 Area Branch Medical Clinic, Bldg 434057, Camp Pendleton, CA 92055 2015-03-20
1154715811 Branch Medical Clinic Area 53 Clinic/Center 53 Area Branch Medical Clinic, Bldg 533020, Camp Pendleton, CA 92055 2015-03-20
1114121449 Naval Hospital Camp Pendleton Clinic/Center Basilone Rd, Bldg 520450, Camp Pendleton, CA 92055-5191 2007-06-12
1972706992 Branch Medical Clinic Camp Pendleton Clinic/Center Bldg 13129 14th Street, Camp Pendleton, CA 92055-5191 2007-06-07
1013110089 Naval Hospital Camp Pendleton Clinic/Center Imhoff Rd, Bldg 210735, Box 555191, Camp Pendleton, CA 92055-5191 2007-06-07
1912100983 Branch Medical Clinic Edson Range Clinic/Center Stuart Mesa Rd, Bldg 310514, Box 555191, Camp Pendleton, CA 92055-5191 2007-06-07
1407823479 Naval Expeditionary Medical Training Institute Clinic/Center 632044 San Mateo Rd, Nomi Det Nemti Box 555223, Camp Pendleton, CA 92055 2006-03-08
1184187296 Intrepid Spirit Center Clinic/Center 200 Mercy Cir, Camp Pendleton, CA 92055 2019-04-08
Find all providers in CAMP PENDLETON

Competitor

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City CAMP PENDLETON
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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