NAVAL MEDICAL CENTER SAN DIEGO (NPI# 1407927494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407927494 |
| Entity Type | Organization |
| Organization Name | NAVAL MEDICAL CENTER SAN DIEGO |
| Other Organization Name | SAN DG SANTEE PHCY |
| Practice Address |
110 Bldg B Town Center Pkwy Santee CA 92134-1098 |
| Practice Telephone | 6196450101 |
| Mailing Telephone | 6196450101 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2019-04-04 |
| Authorized Official Name | MR. WILLIAM MICHAEL CONDON (NAVY MEDICINE UBO PROGRAM MANAGER) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL MEDICAL CENTER SAN DIEGO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| San DG Santee PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700245099 | Naval Medical Center San Diego | Pharmacy | Mcas Miramar Exchange Pharmacy, Bldg 2660, San Diego, CA 92126 | 2016-02-16 |
| 1265846323 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 34800 Bob Wilson Dr Ste 3, San Diego, CA 92134-1003 | 2014-06-17 |
| 1134569924 | Naval Medical Center San Diego | Substance Abuse Rehabilitation Facility | 500 Sylvester Rd, Bldg 500, San Diego, CA 92111 | 2013-06-26 |
| 1508036112 | Naval Medical Center San Diego | Military Hospital | 550 15th Street Unit 709, San Diego, CA 92101 | 2008-03-11 |
| 1982802179 | Naval Medical Center San Diego | Clinic/Center | 120 Town Center Pkwy, Santee, CA 92071-5801 | 2007-07-10 |
| 1205998101 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 34800 Bob Wilson Dr Ste 113, San Diego, CA 92134-1113 | 2006-12-15 |
| 1821197872 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | Bldg 601, San Diego, CA 92135 | 2006-09-22 |
| 1720187776 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 523 S 8th St, Bldg 523, El Centro, CA 92243 | 2006-09-22 |
| 1639278682 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | Bouganville Rd, Bldg 506, San Diego, CA 92155-0001 | 2006-09-22 |
| 1912006966 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 19875 Mitscher Way, Bldg 2495, San Diego, CA 92145-5103 | 2006-09-22 |
| Street Address |
110 BLDG B TOWN CENTER PKWY |
| City | SANTEE |
| State | CA |
| Zip Code | 92134-1098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477178457 | Joseph Hunter Sampson | Military Health Care Provider | 34101 Farenholt Ave #14, San Diego, CA 92134 | 2020-06-15 |
| 1508495201 | Benjamin Michael Taylor | Military Health Care Provider | Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2020-04-04 |
| 1255870333 | Dosh Page | Physician Assistant | Swmi Farenholt Avenue, Building 14, San Diego, CA 92134 | 2017-02-22 |
| 1417328063 | Noem Clay Gallego | Military Health Care Provider | 34101 Building 14, Farenholt Avenue, San Diego, CA 92134 | 2015-10-08 |
| 1972999183 | Justin Paul Lachney | Military Health Care Provider | 34101 Farenholt Avenue, San Diego, CA 92134 | 2015-04-14 |
| 1174963532 | Ryan Anders Crane | Otolaryngology | Department of Otolaryngology - Nmc San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134 | 2013-07-01 |
| 1447591268 | Amy B. Cornell | Student in an Organized Health Care Education/Training Program | 34800 Bob Wilson Drive, San Diego, Ca, Apo, AA 92134 | 2013-03-04 |
| 1841562956 | Christopher Patrick Androski Jr. | Emergency Medical Technician, Basic | Naval Medical Center San Diego 38400 Bob Wilson Dr, San Diego, CA 92134 | 2012-02-04 |
| 1164717740 | Jason James Weiner | Internal Medicine | Dept of Internal Medicine, Division of Rheumatology, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2011-06-13 |
| 1225320237 | Kimberly Ann Thompson | Student in an Organized Health Care Education/Training Program | Navy Medical Center San Diego Gme Department, 34800 Bob Wilson Dr., San Diego, CA 92134 | 2011-05-09 |
| Find all providers in zip 92134 | ||||
| Taxonomy Code | 332000000X |
| Grouping | Suppliers |
| Classification | Military/U.S. Coast Guard Pharmacy |
| A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: new; 7/1/2006: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538251459 | San Dg Santee Phcy | Military/U.S. Coast Guard Pharmacy | 110 Town Center Pkwy, Bldg B, Santee, CA 92701 | 2006-09-28 |
| 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 |
| 1275948143 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Basilone Road, Bldg 520450, Camp Pendleton, CA 92055 | 2014-06-30 |
| 1265846323 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 34800 Bob Wilson Dr Ste 3, San Diego, CA 92134-1003 | 2014-06-17 |
| 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 |
| 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 |
| 1841603248 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Branch Medical Clinic Naf, Bldg 23, El Centro, CA 92055 | 2014-06-04 |
| 1043622681 | David S Grant Medical Center | Military/U.S. Coast Guard Pharmacy | 461 Skymaster Cir Rm 149, Travis Afb, CA 94535-1909 | 2014-06-02 |
| Find all providers with the same taxonomy | ||||
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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.