Justin Carl Carpenter, IDC
Individual provider Active NPI Independent Duty Corpsman · Coronado, CA
NPI 1336079003 · NPPES record last updated May 22, 2026
Key facts
- NPI
- 1336079003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Corpsman 1710I1002X
- Practice address
- 1405 Leyte Rd Apt D
Coronado, CA 92118-3185 - Phone
- (513) 800-6866
- NPI assigned
- May 22, 2026
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Corpsman | 1710I1002X | Yes |
Addresses
Primary practice location
1405 Leyte Rd Apt D
Coronado, CA 92118-3185
Mailing address
1405 Leyte Rd Apt D
Coronado, CA 92118-3185
Phone (513) 800-6866
Other providers in Coronado, CA
- Eileen Anne Callahan
- D Michael Campbell Jr.
- Shelly Suzanne Capitanich
- Antonina Carini
- Colleen Mary Carley
- Gina L. Casian
- Denise Casinelli
- Daryl F Catherwood
- Cep America - Neurology PC
- Jay Michael Channick
All providers in Coronado, CA · Independent Duty Corpsman in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.