Individual provider Active NPI

Joe Gallardo III, IDC

  • Independent Duty Corpsman
  • Camp Pendleton, CA
National Provider Identifier
1043589245
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
22 Area Regimental Aid Station
1St Medical Battalion
Camp Pendleton, CA 92055-5657
Phone
(760) 725-3784
NPI assigned
Dec 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Primary

Addresses

Primary practice location

22 Area Regimental Aid Station
1St Medical Battalion
Camp Pendleton, CA 92055-5657

Mailing address

Box 555657
1St Medical Battalion
Camp Pendleton, CA 92055-5657
Phone (760) 725-3784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1043589245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 555657",
            "address_2": "1ST MEDICAL BATTALION",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555657",
            "telephone_number": "760-725-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 AREA REGIMENTAL AID STATION",
            "address_2": "1ST MEDICAL BATTALION",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555657",
            "telephone_number": "760-725-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLARDO",
        "first_name": "JOE",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-19",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Pendleton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.