Patrick Brian Quill, SOIDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

553A Howard LN
San Clemente, CA 92672-2556

Phone

(714) 944-4469

NPI assigned

Jul 20, 2011

Sex

Male

Sole proprietor

Yes

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": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311120000000",
    "number": "1346538691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 555341",
            "address_2": "1ST MARINE SPECIAL OPERATIONS BN. MEDICAL",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555341",
            "telephone_number": "760-725-5298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553A HOWARD LN",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926722556",
            "telephone_number": "714-944-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUILL",
        "first_name": "PATRICK",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "SOIDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-20",
        "last_updated": "2011-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Independent Duty Corpsman in San Clemente, CA
• Providers in San Clemente, 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 20, 2011; 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.