NAVAL HOSPITAL CAMP PENDLETON (NPI# 1114121449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114121449 |
| Entity Type | Organization |
| Organization Name | NAVAL HOSPITAL CAMP PENDLETON |
| Other Organization Name | BMC SAN ONOFRE MCB |
| Practice Address |
Basilone Rd, Bldg 520450 Camp Pendleton CA 92055-5191 |
| Mailing Address |
Po Box 555191 Fin Mgmt Code 0814 Camp Pendleton CA 92055-5191 |
| Practice Telephone | 7607251621 |
| Practice Fax Number | 7607251661 |
| Mailing Telephone | 7607251621 |
| Mailing Fax Number | 7607251661 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2014-04-10 |
| Authorized Official Name | JAMES H PETERMAN (BUSINESS OFFICE SUPERVISOR) |
| Authorized Official Telephone | 7607251621 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HOSPITAL CA,MP PENDLETON |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PARENT FACILITY NPI | 1386604387 | 01 |
| Other Name | Type Code |
|---|---|
| BMC SAN ONOFRE MCB | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952765125 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 135 Santa Margarita Rd, Camp Pendelton, CA 92055 | 2016-04-13 |
| 1821485152 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Hospital Camp Pendelton, 200 Mercy Circle, Camp Pendelton, CA 92055 | 2015-04-24 |
| 1942697685 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Marine Corps Air Station, Bldg 1175, Yuma, AZ 85369 | 2015-04-21 |
| 1790179455 | Naval Hospital Camp Pendleton | Clinic/Center | 41 Area Branch Medical Clinic, Bldg 414006, Camp Pendleton, CA 92055 | 2015-03-20 |
| 1275948143 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Basilone Road, Bldg 520450, Camp Pendleton, CA 92055 | 2014-06-30 |
| 1285048348 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 41 Area Las Flores Nelson, Bldg 414006, Camp Pendleton, CA 92055 | 2014-06-17 |
| 1205249042 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 13 Area Branch Medic, Bldg 13129 14th St, Camp Pendelton, CA 92055 | 2014-06-10 |
| 1972916740 | Naval Hospital Camp Pendleton | Pharmacy | 52 Area Branch Medical, 540450 Basilone Rd, Camp Pendelton, CA 92055 | 2014-06-09 |
| 1275946444 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Hq Regiment, 16th Street, Camp Pendelton, CA 92055 | 2014-06-05 |
| 1366855538 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Hq Reg 1 Mlg Ras, Bldg 14008, Camp Pendelton, CA 95008 | 2014-06-05 |
| Street Address |
BASILONE RD, BLDG 520450 |
| City | CAMP PENDLETON |
| State | CA |
| Zip Code | 92055-5191 |
| 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 Code | 261QM1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military/U.S. Coast Guard Outpatient |
| 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] |
| 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 |
| 1871832394 | Branch Medical Clinic Area 62 | Clinic/Center | Bldg 620306 8th Street, Camp Pendleton, CA 92055 | 2013-02-04 |
| 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 | ||||
| City | CAMP PENDLETON |
| Zip Code | 92055 |
Please comment or provide details below to improve the information on NAVAL HOSPITAL CAMP PENDLETON.
| 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.