NPIMap

Organization Active NPI

Branch Medical Clinic Bridgeport

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Bridgeport, CA
National Provider Identifier
1083817597
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 BRIDGEPORT
Practice address
MWTC BLDG 3005
Bridgeport, CA 93517
Phone
(760) 830-2498
Fax
(760) 830-2182
NPI assigned
Jun 11, 2007
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 Primary

Addresses

Primary practice location

MWTC BLDG 3005
Bridgeport, CA 93517

Mailing address

1145 Sturgess Street, Box 788250
Attn: Financial Technician
Twentynine Palms, CA 92277-8250
Phone (760) 830-2498

National Provider Directory

National Provider Directory
Tax ID family
Branch Medical Clinic China Lake6 organizations share this tax ID, including this one
Part of
Branch Medical Clinic China Lake

Other organizations with this tax ID 5

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508112000000",
    "number": "1083817597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 STURGESS STREET, BOX 788250",
            "address_2": "ATTN: FINANCIAL TECHNICIAN",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922778250",
            "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": "MWTC BLDG 3005",
            "city": "BRIDGEPORT",
            "state": "CA",
            "postal_code": "93517",
            "telephone_number": "760-830-2498",
            "fax_number": "760-830-2182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH MEDICAL CLINIC BRIDGEPORT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL HOSPITAL TWENTYNINE PALMS",
        "enumeration_date": "2007-06-11",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, 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.