BENJAMIN ALEXANDER SEBREROS (NPI# 1902393176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902393176 |
Entity Type | Individual |
Full Name | BENJAMIN ALEXANDER SEBREROS |
Credential | DO |
Practice Address |
2446 Trident Way Bldg 637 San Diego CA 92155-0001 |
Mailing Address |
2446 Trident Way Bldg 637 San Diego CA 92155-5494 |
Practice Telephone | 6194372581 |
Mailing Telephone | 6194372581 |
Enumeration Date | 2018-04-13 |
Last Update Date | 2019-11-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Street Address |
2446 TRIDENT WAY BLDG 637 |
City | SAN DIEGO |
State | CA |
Zip Code | 92155-0001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578941597 | Zenus Joe Wilson | General Practice | 2446 Trident Way Bldg 637, San Diego, CA 92155-5494 | 2015-05-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134454770 | Carrie Lynn Decker | Military Health Care Provider | Eod Exp Support Unit One, 3502 Attu Rd Bldg 326 San Diego Ca, Apo, AA 92155 | 2009-10-15 |
1578779559 | Joe Leonard Bonvie | Psychologist | Naval Special Warfare Command, Medical Dept Code 04, 2000 Trident Way, San Diego, CA 92155 | 2007-05-15 |
1134350226 | Christopher Robert Terry | Military Health Care Provider | 2446 Trident Way, Coranado, CA 92155 | 2009-08-06 |
1003840653 | Robert David Gerardi | Military Health Care Provider | 2841 Rendova Road, San Diego, CA 92155 | 2006-07-10 |
1346597234 | Jermy Joe Brower | Military Health Care Provider | Seal Team One 2534 Trident Way Bldg 614, San Diego, CA 92155-0001 | 2012-08-09 |
1720376684 | Brittany A Hout | Physician Assistant | Anaconda Rd Bldg 262, San Diego, CA 92155-0001 | 2011-07-13 |
1639278682 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | Bouganville Rd, Bldg 506, San Diego, CA 92155-0001 | 2006-09-22 |
1790056372 | U. S. Navy | Military Hospital | 3423 Guadalcanal Rd, Bldg 401 2nd Deck, San Diego, CA 92155-5000 | 2012-01-13 |
1366592248 | Robert Ray Lowe Jr. | Emergency Medicine | 3400 Tarawa Rd, San Diego, CA 92155-5002 | 2007-01-11 |
1801868633 | Michael Griffin Swanson | Family Medicine | Naval Special Warfare Group Three, 3400 Tarawa Road Bldg.19, San Diego, CA 92155-5002 | 2006-02-06 |
Find all providers in zip 92155 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033716204 | Julianne A. Demery | Student in an Organized Health Care Education/Training Program | Naval Base San Diego 2450 Craven Street #3300, San Diego, CA 92136-0001 | 2020-10-01 |
1649885732 | Leanne Evalyn Morancie | Student in an Organized Health Care Education/Training Program | 4231 Balboa Ave # 1245, San Diego, CA 92117-5504 | 2020-09-15 |
1689288136 | Melissa Eileen Fitzgibbon | Student in an Organized Health Care Education/Training Program | 5114 63rd St, San Diego, CA 92115-1407 | 2020-09-02 |
1316550510 | Jessica Elizabeth Knight | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Ct, 310, San Diego, CA 92120 | 2020-08-26 |
1770195091 | Julia Roccanova | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Court, Suite 310, San Diego, CA 92120 | 2020-08-18 |
1861004392 | Mareena Biju | Student in an Organized Health Care Education/Training Program | 10995 Evening Creek Dr E, San Diego, CA 92128-4009 | 2020-08-17 |
1184235202 | Taylor G Wasko | Student in an Organized Health Care Education/Training Program | 4114 Swift Ave Apt 4, San Diego, CA 92104-2249 | 2020-08-12 |
1790394245 | Elisa Melo Da Silva Smerik | Student in an Organized Health Care Education/Training Program | 3235 Loma Riviera Dr, San Diego, CA 92110-5511 | 2020-07-29 |
1215554076 | Ana Mohammad-zadeh | Student in an Organized Health Care Education/Training Program | 17289 Russet St, San Diego, CA 92127-2135 | 2020-06-28 |
1265056048 | Tilbe Yildirim | Student in an Organized Health Care Education/Training Program | 1963 Fourth Ave., San Diego, CA 92101 | 2020-06-08 |
Find all providers in SAN DIEGO |
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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.