60TH MEDICAL GROUP SGSL (NPI# 1528167582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528167582 |
| Entity Type | Organization |
| Organization Name | 60TH MEDICAL GROUP SGSL |
| Other Organization Name | TRAVIS 1ST FLR OP PHCY |
| Practice Address |
101 Bodin Cir Rm 1c409 Travis Afb CA 94535-1809 |
| Practice Telephone | 7074237114 |
| Practice Fax Number | 7074237994 |
| Mailing Telephone | 7074237114 |
| Mailing Fax Number | 7074237994 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2016-01-21 |
| Authorized Official Name | HECTOR MORALES (CHIEF DHA PASS) |
| Authorized Official Telephone | 2105366650 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2115843 | 01 |
| Other Name | Type Code |
|---|---|
| TRAVIS 1ST FLR OP PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942309919 | 60th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Skymaster Blvd Bldg 650 Rm 149, Travis Afb, CA 94535-1800 | 2006-09-22 |
| 1346349305 | 60th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 101 Bodin Cir Rm 1c409, Travis Afb, CA 94535-1809 | 2006-09-22 |
| 1265531222 | 60th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Skymaster Blvd Bldg 650 Rm 149, Travis Afb, CA 94535-1800 | 2006-09-22 |
| Street Address |
101 BODIN CIR RM 1C409 |
| City | TRAVIS AFB |
| State | CA |
| Zip Code | 94535-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346349305 | 60th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 101 Bodin Cir Rm 1c409, Travis Afb, CA 94535-1809 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
| 1568081255 | Miguel Julian Moreno | Student in an Organized Health Care Education/Training Program | 690 Airmen Drive, Travis Afb, CA 94535 | 2020-04-13 |
| 1174096101 | Zlatoslava Karga | Nurse Practitioner | 60mdg / Sgow, 101 Bodin Circle, Travis Afb, CA 94535 | 2019-01-02 |
| 1437648292 | Luke C Vera | Dentist | David Grant Medical Center 101 Bodin Circle, Travis Air Force Base, CA 94535 | 2018-05-08 |
| 1588163430 | Sanaz Ziad | Pharmacist | 60mdg/mdts, 101 Bodin Circle, Travis Afb, CA 94535 | 2018-02-06 |
| 1194265686 | Geoffrey Johnston | Dentist | 60 Mdg/sgdd, 101 Bodin Circle, Travis Afb, CA 94535 | 2017-03-02 |
| 1336693407 | Hannah Isla Nordwall | Social Worker | 60 Mdg/mdos 101 Bodin Cir, Travis Afb, CA 94535 | 2016-08-06 |
| 1184177149 | Taylor Murrie-robinson | Social Worker | 60mdg / Sgow Mental Health Clinic, 101 Bodin Circle, Travis Afb, CA 94535 | 2016-07-26 |
| 1952759607 | Eric Kincaid-sharp | General Practice | 60 Mdg/amds, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-06-02 |
| 1023472040 | Genieve Marie Martinez-hernandez | Internal Medicine | 60 Mdg/sgomi, 101 Bodin Circle, Fairfield, CA 94535 | 2016-04-06 |
| Find all providers in zip 94535 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1942309919 | 60th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Skymaster Blvd Bldg 650 Rm 149, Travis Afb, CA 94535-1800 | 2006-09-22 |
| 1346349305 | 60th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 101 Bodin Cir Rm 1c409, Travis Afb, CA 94535-1809 | 2006-09-22 |
| 1265531222 | 60th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Skymaster Blvd Bldg 650 Rm 149, Travis Afb, CA 94535-1800 | 2006-09-22 |
| 1205896701 | David Grant Medical Center | Military/U.S. Coast Guard Pharmacy | 101 Bodin Cir, 60th Medical Group, Travis Afb, CA 94535-1809 | 2006-03-27 |
| 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 |
| 1154733947 | Naval Hospital Twentynine Palms | Military/U.S. Coast Guard Pharmacy | 1151 Sturgis Street, Twentynine Palms, CA 92278-8250 | 2014-05-28 |
| Find all providers with the same taxonomy | ||||
| City | TRAVIS AFB |
| Zip Code | 94535 |
Please comment or provide details below to improve the information on 60TH MEDICAL GROUP SGSL.
| 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.