NPIMap

Organization Active NPI

Branch Medical Clinic Coronado

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • San Diego, CA
National Provider Identifier
1225220270
Registry record updated Apr 4, 2019
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 CORONADO
Practice address
601 McCain Blvd
Naval Base Coronado
San Diego, CA 92135-7046
Phone
(619) 545-7245
NPI assigned
Aug 14, 2007
Last updated
Apr 4, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
NAVAL MEDICAL CENTER SAN DIEGOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Authorized official

Name
Mr. William Michael Condon
Title
Navy Medicine Ubo Program Manager
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

601 McCain Blvd
Naval Base Coronado
San Diego, CA 92135-7046

Mailing address

Naval Base Coronado BLD 601 McCain Blvd
Branch Medical Clinic
San Diego, CA 92135

National Provider Directory

National Provider Directory
Tax ID family
Naval Medical Center San Diego26 organizations share this tax ID, including this one
Part of
Naval Medical Center San Diego

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1225220270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL BASE CORONADO BLD 601 MCCAIN BLVD",
            "address_2": "BRANCH MEDICAL CLINIC",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MCCAIN BLVD",
            "address_2": "NAVAL BASE CORONADO",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921357046",
            "telephone_number": "619-545-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH MEDICAL CLINIC CORONADO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL MEDICAL CENTER SAN DIEGO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "NAVY MEDICINE UBO PROGRAM MANAGER",
        "authorized_official_telephone_number": "240-401-3643",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; 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.