NAVAL MEDICAL CENTER SAN DIEGO (NPI# 1821197872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821197872 |
| Entity Type | Organization |
| Organization Name | NAVAL MEDICAL CENTER SAN DIEGO |
| Other Organization Name | SAN DG NORTH ISLAND PHCY |
| Practice Address |
Bldg 601 San Diego CA 92135 |
| Practice Telephone | 6195454290 |
| Practice Fax Number | 6195325898 |
| Mailing Telephone | 6195454290 |
| Mailing Fax Number | 6195325898 |
| Enumeration Date | 2006-09-22 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2027430 | 01 |
| Other Name | Type Code |
|---|---|
| SAN DG NORTH ISLAND 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 |
| 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 |
| 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 |
BLDG 601 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053872275 | Erika Hernandez | Dental Hygienist | 600 Mc Cain Blvd, San Diego, CA 92135 | 2019-03-29 |
| 1144723289 | Andrew T Bagby | General Practice | 601 Mc Cain Blvd, San Diego, CA 92135 | 2018-03-15 |
| 1780124792 | Larry Alenbaugh Optometry | Optometrist | Nas North Island Building 2017, San Diego, CA 92135 | 2017-02-24 |
| 1215389507 | Dana Gampel | Optometrist | Nas North Island Nex Building 2017, San Diego, CA 92135 | 2016-07-11 |
| 1801288634 | Branch Medical Clinic Nalf San Clemente Island | Clinic/Center | Wilson Cove, Bldg 60126, San Clemente, CA 92135 | 2015-03-03 |
| 1902213598 | Armin Villanueva | Dental Hygienist | Mcain Blvd Building 600, San Diego, CA 92135 | 2014-07-16 |
| 1114366226 | Jennifer J Miller | Dental Hygienist | Bldg 600 Mccain Blvd, Branch Dental Clinic North Island, San Diego, CA 92135 | 2013-06-21 |
| 1902159916 | Alexis Guadalupe Chavez | Military Health Care Provider | 601 Mccain Blvd Bldg 601, Naval Air Station North Island, Coronado, CA 92135 | 2012-10-16 |
| 1295040426 | Linda Anona Farmer | Military Health Care Provider | Bldg 601 Mccain Blvd Bmc Naval Base Coronado, San Diego, CA 92135 | 2010-08-12 |
| 1508006149 | Kathy Rebecca Sullivan | Military Health Care Provider | Msron Five Medical Department, Nolf Ib Building 169, San Diego, CA 92135 | 2009-02-23 |
| Find all providers in zip 92135 | ||||
| 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 |
| 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 |
| 1063766459 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 11770 Bernardo Plaza Ct, Suite 250, San Diego, CA 92128-2422 | 2012-11-07 |
| 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.