NPIMap

Organization Active NPI

Air Force

  • Military Hospital
  • Fairfield, CA
National Provider Identifier
1013079334
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military HospitalTaxonomy code 286500000X
License
4679 Issued in PR
Legal business name
AIR FORCE
Practice address
2569 Shorey Way
Fairfield, CA 94533-6562
Phone
(707) 816-8622
NPI assigned
Dec 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marcos J LopezNPI 1730340258
Title
Clinical Pharmacist
Phone
(707) 423-3459

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military Hospital 286500000X 4679 PR Primary

Addresses

Primary practice location

2569 Shorey Way
Fairfield, CA 94533-6562

Mailing address

2569 Shorey Way
Fairfield, CA 94533-6562

Other names 1

  • David Grant Medical Center Other name

National Provider Directory

National Provider Directory
Tax ID family
60TH Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013079334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2569 SHOREY WAY",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2569 SHOREY WAY",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336562",
            "telephone_number": "707-816-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIR FORCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "MARCOS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CLINICAL PHARMACIST",
        "authorized_official_telephone_number": "707-423-3459"
    },
    "taxonomies": [
        {
            "code": "286500000X",
            "taxonomy_group": "",
            "desc": "Military Hospital",
            "state": "PR",
            "license": "4679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David Grant Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.