9TH MEDICAL GROUP (NPI# 1790884740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790884740 |
| Entity Type | Organization |
| Organization Name | 9TH MEDICAL GROUP |
| Other Organization Name | BEALE MAIN PHCY |
| Practice Address |
15301 Warren Shingle Rd Beale Afb CA 95903-1907 |
| Mailing Address |
David S Grant Medical Center C/o 60th Mdg 101 Bodin Cir Travis Afb CA 94535-1809 |
| Practice Telephone | 5306342337 |
| Practice Fax Number | 5303464653 |
| Mailing Telephone | 5306342337 |
| Mailing Fax Number | 5303464653 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2015-05-27 |
| 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 | 2103361 | 01 |
| Other Name | Type Code |
|---|---|
| BEALE MAIN PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518366574 | 9th Medical Group | Military/U.S. Coast Guard Pharmacy | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2014-08-15 |
| 1184695991 | 9th Medical Group | Military/U.S. Coast Guard Pharmacy | 15301 Warren Shingle Rd, Bldg 5706, Beale Afb, CA 95903-1907 | 2006-01-30 |
| Street Address |
15301 WARREN SHINGLE RD |
| City | BEALE AFB |
| State | CA |
| Zip Code | 95903-1907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831182047 | Sadina Lynn Brecheisen-beach | Nurse Practitioner | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2005-08-24 |
| 1407472111 | Shalaleh Khoei | Dietitian, Registered | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2020-06-18 |
| 1902443476 | Thuy-trang Thu Lam | Pharmacist | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2019-12-04 |
| 1558920819 | Madison Lee Kernick | Dentist | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2019-06-11 |
| 1669039525 | Dustin Lansing Bennett | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2019-05-24 |
| 1760944607 | David Chou | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2019-04-01 |
| 1548721244 | Nicolas Lara | Internal Medicine | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2019-03-26 |
| 1265901920 | Brianna Lee Holmes | Pharmacist | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2018-11-24 |
| 1861973513 | Ryan Joel Banci Mintalar | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2018-08-21 |
| 1336634823 | Erika Jennifer Reid | Social Worker | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2018-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962575969 | Linda Lee Currier | Physical Therapist | 9 Medical Group, 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2006-11-16 |
| 1700984853 | Kimberly D Kumer | Psychiatry & Neurology | 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2006-09-20 |
| 1780637124 | Lillie M Mells | Social Worker | 9mdos/sgoh, 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2006-05-18 |
| 1003109844 | Jerrica Marie Wild | Military Health Care Provider | 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2011-05-26 |
| 1962413773 | William F Nakashima | Internal Medicine | 414 G St, Suite 106, Marysville, CA 95903 | 2006-08-10 |
| 1417999228 | Frank Peter Baccelli | Dentist | 15337 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2006-06-13 |
| 1245389071 | Kelly Neil West | Family Medicine | 9th Medical Group, 15301 Warren Shingle Road, Beale Afb, CA 95903-1907 | 2007-01-10 |
| 1912456369 | Martha Lawder | Dietitian, Registered | 15301 Warren Shingle Road, Beale, CA 95903-1907 | 2016-09-27 |
| 1487799755 | Dianna M. Garbett | Counselor | 15301 Warren Shingle Road, 9 Mdos Sgohf, Beale Afb, CA 95903-1907 | 2007-02-21 |
| 1770027807 | Maura Scolese | Physical Therapist | 3386 Loma Dr, Beale Afb, CA 95903-2122 | 2016-12-08 |
| Find all providers in zip 95903 | ||||
| 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 |
|---|---|---|---|---|
| 1518366574 | 9th Medical Group | Military/U.S. Coast Guard Pharmacy | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2014-08-15 |
| 1184695991 | 9th Medical Group | Military/U.S. Coast Guard Pharmacy | 15301 Warren Shingle Rd, Bldg 5706, Beale Afb, CA 95903-1907 | 2006-01-30 |
| 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 |
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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.