MR. CARLOS M. COLEMAN (NPI# 1851368229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851368229 |
| Entity Type | Individual |
| Full Name | MR. CARLOS M. COLEMAN |
| Credential | IDC |
| Practice Address |
34101 Farenholt Ave Nshs-sd Idc Dept San Diego CA 92134-7000 |
| Mailing Address |
1418 Trailwood Ave Chula Vista CA 91913-2964 |
| Practice Telephone | 6195325109 |
| Mailing Telephone | 6199855915 |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| Street Address |
34101 FARENHOLT AVE NSHS-SD IDC DEPT |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92134-7000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376522193 | Anna Gruetzmacher | Registered Nurse | 34101 Farenholt Ave, Nshs-sd Idc, San Diego, CA 92134-7000 | 2006-01-11 |
| 1992316541 | Michael Trey Wix | Military Health Care Provider | 34101 Farenholt Ave, San Diego, CA 92134-7000 | 2020-08-16 |
| 1063023737 | James Anthony Lukas IIi | Military Health Care Provider | 34101 Farenholt Ave, San Diego, CA 92134-7000 | 2020-08-14 |
| 1477164143 | Evan Lewis Ridenour | Military Health Care Provider | 34101 Farenholt Ave, San Diego, CA 92134-7000 | 2020-08-14 |
| 1295353175 | Derek R Summers | Military Health Care Provider | 34101 Farenholt Ave, San Diego, CA 92134-7000 | 2020-07-08 |
| 1992326854 | Brandon Ponder | Military Health Care Provider | 34101 Farenholt Ave, San Diego, CA 92134-7000 | 2020-05-01 |
| 1912535493 | Michael Johnson | Military Health Care Provider | 34101 Farenholt Ave, San Diego, CA 92134-7000 | 2020-03-30 |
| 1023655313 | Kayla Seim | Military Health Care Provider | 34101 Farenholt Ave, San Diego, CA 92134-7000 | 2019-12-05 |
| 1871130104 | Eric Ancheta | Military Health Care Provider | 34101 Farenholt Ave, San Diego, CA 92134-7000 | 2019-12-05 |
| 1811533656 | Andres Ricardo Castaneda | Military Health Care Provider | 34101 Farenholt Ave, San Diego, CA 92134-7000 | 2019-11-26 |
| Find all providers in the same location | ||||
| 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 | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093124398 | Benjamin Ryan Foy | Military Health Care Provider | 2784 Hornet Way, San Diego, CA 92106-6421 | 2014-08-12 |
| 1346552064 | Jeffrey Thomas Gilbert | Military Health Care Provider | 3841 Colina Dorado Dr, Apartment G108, San Diego, CA 92124 | 2010-07-10 |
| 1467674150 | John Dudley Harris Jr. | Military Health Care Provider | 33000 Nixie Way Bldg 50, San Diego, CA 92147-5101 | 2007-05-03 |
| 1730157736 | Alfredo Alcalaesparza | Military Health Care Provider | 2211 Pacific Beach Dr, San Diego, CA 92109-5626 | 2006-03-08 |
| 1447606322 | Jeffrey Tyler Whitson | Military Health Care Provider | 34101 Farenholt Ave, Building 14, San Diego, CA 92134-7000 | 2016-05-10 |
| 1497927404 | Keren Mireya Lemas | Military Health Care Provider | 2450 Craven St, San Diego, CA 92136-5599 | 2008-03-31 |
| 1689873192 | Keith Robert Davis | Military Health Care Provider | 140 Sylvester Rd, Uss Topeka (ssn 754) Fpo Ap 96679-2410, San Diego, CA 92106-3521 | 2007-07-13 |
| 1740481571 | Cindy S Cruzan | Military Health Care Provider | 34101 Farenholt Ave, San Diego, CA 92134-7000 | 2007-05-30 |
| 1932169380 | Shirley Hovlid | Military Health Care Provider | 2650 Stockton Rd, San Diego, CA 92106-6000 | 2006-03-27 |
| 1023085883 | Anthony Petrone Jr. | Military Health Care Provider | 140 Sylvester Rd, San Diego, CA 92106-3521 | 2006-03-01 |
| 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.