U.S. Coast Guard

Primary specialty

Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X

Legal business name

U.S. COAST GUARD

Practice address

2734 Belknap Way
San Diego, CA 92106-6401

Phone

(619) 944-4859

NPI assigned

Jan 30, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gerry Rodriguez

Title

Clinic Administrator

Phone

(619) 524-5204

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104962448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2734 BELKNAP WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2734 BELKNAP WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066401",
            "telephone_number": "619-944-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "U.S. COAST GUARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "GERRY",
        "authorized_official_title_or_position": "CLINIC  ADMINISTRATOR",
        "authorized_official_telephone_number": "619-524-5204"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Military/U.S. Coast Guard Outpatient Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Military/U.S. Coast Guard Outpatient Clinic/Center in California

• 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.