Individual provider Active NPI

Andrew Isais, DEEP SEA DIVE IDC

  • Independent Duty Corpsman
  • San Diego, CA
National Provider Identifier
1437760105
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
34800 Bob Wilson Dr Naval Medical Center San Diego
San Diego, CA 92134-0001
Phone
(619) 532-6400
NPI assigned
Aug 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Primary

Addresses

Primary practice location

34800 Bob Wilson Dr Naval Medical Center San Diego
San Diego, CA 92134-0001

Mailing address

6207 Paseo Encantada
Camarillo, CA 93012-9421
Phone (805) 827-0529

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address andrew.t.isais.mil@mail.mil Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1437760105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6207 PASEO ENCANTADA",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930129421",
            "telephone_number": "805-827-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR NAVAL MEDICAL CENTER SAN DIEGO",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921340001",
            "telephone_number": "619-532-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAIS",
        "first_name": "ANDREW",
        "credential": "DEEP SEA DIVE IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-14",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrew.t.isais.mil@mail.mil",
            "affiliation": "N",
            "endpointDescription": "E-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "E-mail",
            "address_1": "34800 Bob Wilson Dr Naval Medical Center San Diego",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921340001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Aug 14, 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.