NAVAL MEDICAL CENTER SAN DIEGO (NPI# 1700245099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700245099 |
| Entity Type | Organization |
| Organization Name | NAVAL MEDICAL CENTER SAN DIEGO |
| Other Organization Name | SAN DG MCX MIRAMAR PHCY |
| Practice Address |
Mcas Miramar Exchange Pharmacy Bldg 2660 San Diego CA 92126 |
| Mailing Address |
34520 Bob Wilson Dr Ste 20 San Diego CA 92134-2098 |
| Practice Telephone | 8585779960 |
| Mailing Telephone | 8585779960 |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2016-02-29 |
| 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 |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2158076 | 01 |
| Other Name | Type Code |
|---|---|
| SAN DG MCX MIRAMAR PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1407927494 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 110 Bldg B Town Center Pkwy, Santee, CA 92134-1098 | 2006-11-13 |
| 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 |
MCAS MIRAMAR EXCHANGE PHARMACY BLDG 2660 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730741299 | Eye Connection Optometry, Inc | Optometrist | 9516 Miramar Road, San Diego, CA 92126 | 2019-07-05 |
| 1811450935 | Anne Phabmixay | Student in an Organized Health Care Education/Training Program | Douglas Young Wellness Center, 10717 Camino Ruiz Suite 207, San Diego, CA 92126 | 2019-04-08 |
| 1679035588 | Emily Nguyen | Registered Nurse | 8210 Elston Place, San Diego, CA 92126 | 2019-04-01 |
| 1558832139 | Dana Douglas-hiley | Speech-Language Pathologist | 9606 Tierra Grande St., Suite 107, San Diego, CA 92126 | 2018-12-08 |
| 1275022873 | Breeann Nicole Poulson | Speech-Language Pathologist | 9466 Black Mountain Rd Suite 100, San Diego, CA 92126 | 2018-05-09 |
| 1659878882 | My Phuong Thi Phan | Registered Nurse | 10938 Hyades Way, San Diego, CA 92126 | 2018-04-13 |
| 1083132153 | Ruth Tamar Morales | Occupational Therapist | Children's Ot Services, Inc, 9606 Tierra Grande St., #104, San Diego, CA 92126 | 2017-09-08 |
| 1487184339 | Chelsea Irene Johnson | Marriage & Family Therapist | 8670 New Salem St. Unit 106, San Diego, CA 92126 | 2017-06-14 |
| 1336508506 | Brenda L. Bebal | Nurse Practitioner | 10737 Camino Ruiz; Ste 235, Operation Samahan Health Clinic, San Diego, CA 92126 | 2016-02-17 |
| 1821464835 | Anne Michelle Gungon Everhart | Registered Nurse | 10737 Camino Ruiz, Suite 235, Operation Samahan Community Health Center, San Diego, CA 92126 | 2015-08-12 |
| Find all providers in zip 92126 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| 1730288788 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 25000 Guadal Canal Rd, Bldg 256, San Diego, CA 92140 | 2006-09-22 |
| 1003915059 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 32 Nd St Navy Exchange, Bldg 3187, San Diego, CA 92136-0001 | 2006-09-22 |
| 1750480794 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | Business Office Code Rbe, 34520 Bob Wilson Dr Ste 20, San Diego, CA 92134-2020 | 2006-09-22 |
| 1962501924 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | Naval Medical Centerpharmacy Dept, 34800 Bob Wilson Drive, San Diego, CA 92134-0001 | 2006-09-22 |
| 1366856437 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 34800 Bob Wilson Dr Ste 1, San Diego, CA 92134-5000 | 2014-06-17 |
| 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.