Byron Pack, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

533020 Basoline Rd
Camp Horno
Camp Pendleton, CA 92055-5402

Phone

(760) 725-7410

Fax

(760) 725-7663

NPI assigned

Jan 31, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295872232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 W THORNTON AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925459129",
            "telephone_number": "951-766-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533020 BASOLINE RD",
            "address_2": "CAMP HORNO",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555402",
            "telephone_number": "760-725-7410",
            "fax_number": "760-725-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "BYRON",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Joseph Oshaughnessy, SOIDC
• Alexander Ostrizhnyuk, SOIDC
• Vasiliy Ovakimyan
• James Devin Owens, D.O.
• Kyle Michael Pacheco, FMF RECON IDC
• Emma J Par, M.D.
• Scott Paradise, MD
• Allen Christopher Pate, IDC
• Michael Patrick, MD
• Cheryl L Patzer, O.D.

• Independent Duty Corpsman in Camp Pendleton, CA
• Providers in Camp Pendleton, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.