CARLETUS M PATRICK (NPI# 1013195718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013195718 |
| Entity Type | Individual |
| Full Name | CARLETUS M PATRICK |
| Credential | IDC |
| Practice Address |
2450 Craven St San Diego CA 92136-5599 |
| Mailing Address |
1616 San Bernardino Ave Spring Valley CA 91977-4650 |
| Practice Telephone | 6195566081 |
| Mailing Telephone | 6196949040 |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2011-09-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| 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 |
2450 CRAVEN ST |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92136-5599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649276288 | Jennifer Elizabeth Tonge-martin | Nurse Practitioner | 2450 Craven St, San Diego, CA 92136-5599 | 2005-06-27 |
| 1699070987 | Christopher James Tilley | Military Health Care Provider | 2450 Craven St, Bldg 3300, San Diego, CA 92136-5599 | 2011-01-18 |
| 1790089910 | Curtis Ryan Stubblefield | Physician Assistant | 2450 Craven St, Branch Health Clinic Navla Base San Diego, San Diego, CA 92136-5599 | 2011-01-03 |
| 1245542364 | Kimberly Leeniese Chavez | Military Health Care Provider | 2450 Craven St, Branch Medical Clinic Naval Station Bldg 3300, San Diego, CA 92136-5599 | 2010-07-06 |
| 1518118546 | Estrellita Delrosar Edmond | Military Health Care Provider | 2450 Craven St, San Diego, CA 92136 | 2008-10-08 |
| 1043486418 | Joshua David French | Military Health Care Provider | 2450 Craven St, San Diego, CA 92136-5599 | 2008-05-05 |
| 1144496670 | Tijani Bamidele Abdulsalam | Military Health Care Provider | 2450 Craven St, San Diego, CA 92136-5599 | 2008-05-05 |
| 1497927404 | Keren Mireya Lemas | Military Health Care Provider | 2450 Craven St, San Diego, CA 92136-5599 | 2008-03-31 |
| 1326132754 | Suriti Kundu | Family Medicine | 2450 Craven St, Branch Medical Clinic Naval Base, San Diego, CA 92136-5599 | 2006-10-02 |
| 1124125984 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 2450 Craven St, Bldg 3300, San Diego, CA 92136-5599 | 2006-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467930164 | Alexa Clifton | Student in an Organized Health Care Education/Training Program | 2525 Callagan Hwy, Fpo, AA 92136 | 2018-08-03 |
| 1235501321 | Family Optometric Associates of California, Inc. | Optometrist | 2260 Callahan Hwy, Bldg 3187-a, San Diego, CA 92136 | 2015-10-28 |
| 1457720427 | Andres Bargados Santamaria IIi | Military Health Care Provider | 116 Cummings Rd, San Diego, CA 92136 | 2015-09-21 |
| 1932470374 | Robert Bishop Beedles Jr. | Military Health Care Provider | 3380 Sturtevant St, Bldg 57 Second Floor, San Diego, CA 92136 | 2012-01-17 |
| 1083771877 | Brianna Leigh Rupp | General Practice | Uss Tarawa Lha 1 Fpo Ap 96622-1600, San Diego, CA 92136 | 2007-01-02 |
| 1396814836 | Alberia Joseph Davis | Military Health Care Provider | Pcd Sampson (ddg-102), 3975 Norman Scott Rd, San Diego, CA 92136 | 2006-11-07 |
| 1831275866 | Roslyn Jones Jackson | Nurse Practitioner | 2450 Craven Streeet, San Diego, CA 92136 | 2006-10-31 |
| 1699743534 | Mark L Williamson | Military Health Care Provider | 3325 Senn Road, Comdesron One Building 55 Second Floor, San Diego, CA 92136 | 2006-03-08 |
| 1467423335 | John M. Hintz | Psychologist | Branch Medical Clinic, Naval Station, San Diego, CA 92136 | 2006-01-30 |
| 1659341089 | Kenichi Carrigan | Preventive Medicine | 3235 Albacore Alley, San Diego, CA 92136 | 2006-01-26 |
| Find all providers in zip 92136 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1255945069 | Jeremy Lee | Military Health Care Provider | 509 Dennery Rd Apt 145, San Diego, CA 92154-8542 | 2020-08-31 |
| 1013520667 | Rashaad Brown | Military Health Care Provider | 4454 Cherokee Ave Apt 2, San Diego, CA 92116-3611 | 2020-08-24 |
| 1932711934 | Alvaro Daniel Macias | Military Health Care Provider | 8685 Rio San Diego Dr Apt 4344, San Diego, CA 92108-6560 | 2020-08-20 |
| 1689286189 | Charles Luke Morris | Military Health Care Provider | 1675 Beta Ct, San Diego, CA 92126-7060 | 2020-08-18 |
| 1255943635 | Stephon Peyton Frost | Military Health Care Provider | 2654 Mendonca Dr, San Diego, CA 92110-4263 | 2020-08-18 |
| 1184235871 | Jaden Sandi | Military Health Care Provider | Swmi Sfidc Bldg 14 34101 Farenholt Ave, San Diego, CA 92134-0001 | 2020-08-14 |
| 1477178457 | Joseph Hunter Sampson | Military Health Care Provider | 34101 Farenholt Ave #14, San Diego, CA 92134 | 2020-06-15 |
| 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.