NPIMap

Organization Active NPI

Branch Medical Clinic China Lake

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Ridgecrest, CA
National Provider Identifier
1023212677
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
BRANCH MEDICAL CLINIC CHINA LAKE
Practice address
1 Administration Cir
Ridgecrest, CA 93555-6104
Phone
(760) 830-2498
Fax
(760) 830-2182
NPI assigned
Jun 14, 2007
Last updated
Oct 16, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
NAVAL HOSPITAL TWENTYNINE PALMSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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

Authorized official

Name
William M Condon
Title
Bumed Ubo
Phone
(240) 401-3643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X NU Primary

Addresses

Primary practice location

1 Administration Cir
Ridgecrest, CA 93555-6104

Mailing address

1 Administration Cir
Ridgecrest, CA 93555-6104
Phone (760) 830-2498

Other identifiers 2

IdentifierTypeStateIssuer
5662OtherCABLUE CROSS BLUE SHIELD
NOT REQUIREDOtherCAMAILHANDLERS BENEFIT PLAN

National Provider Directory

National Provider Directory
Tax ID family
Branch Medical Clinic Bridgeport6 organizations share this tax ID, including this one
Part of
Branch Medical Clinic Bridgeport

Other organizations with this tax ID 5

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

Locations

1 Administration Cir
Ridgecrest, CA 93555
Phone (760) 830-2498

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508112000000",
    "number": "1023212677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ADMINISTRATION CIR",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935556104",
            "telephone_number": "760-830-2498",
            "fax_number": "760-830-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ADMINISTRATION CIR",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935556104",
            "telephone_number": "760-830-2498",
            "fax_number": "760-830-2182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH MEDICAL CLINIC CHINA LAKE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL HOSPITAL TWENTYNINE PALMS",
        "enumeration_date": "2007-06-14",
        "last_updated": "2017-10-16",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUMED UBO",
        "authorized_official_telephone_number": "240-401-3643"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5662",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAILHANDLERS BENEFIT PLAN",
            "identifier": "NOT REQUIRED",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgecrest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2017; 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.