Air Force

Organization Active NPI Military Hospital · Fairfield, CA

NPI 1013079334 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1013079334
Entity type
Organization (NPI type 2)
Primary specialty
Military Hospital 286500000X
License
4679 (PR)
Legal business name
AIR FORCE
Practice address
2569 Shorey Way
Fairfield, CA 94533-6562
Phone
(707) 816-8622
NPI assigned
Dec 14, 2006
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 1

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

National Provider Directory

Tax ID family
60TH Medical Group (2 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

2569 Shorey Way
Fairfield, CA 94533-6562

Mailing address

2569 Shorey Way
Fairfield, CA 94533-6562

Other names

  • David Grant Medical Center Other name

Other providers in Fairfield, CA

All providers in Fairfield, CA · Military Hospital in California

Sources for this page

Verify at the official NPI Registry.