Individual provider Active NPI

Jesedh Nunez Miranda, HOSPITAL CORPSMAN

  • Independent Duty Corpsman
  • San Diego, CA
National Provider Identifier
1487428249
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
34101 Farenholt Ave BLDG 14
San Diego, CA 92134-7000
Phone
(619) 532-7968
NPI assigned
Nov 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

34101 Farenholt Ave BLDG 14
San Diego, CA 92134-7000

Mailing address

3696 Argonne St
San Diego, CA 92117-1011
Phone (787) 525-2826

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

Practice roles

OrganizationSpecialtyStatusNew patients
United States Navy PastSince Nov 19, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1487428249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3696 ARGONNE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921171011",
            "telephone_number": "787-525-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34101 FARENHOLT AVE BLDG 14",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921347000",
            "telephone_number": "619-532-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNEZ MIRANDA",
        "first_name": "JESEDH",
        "credential": "HOSPITAL CORPSMAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "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": []
}

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 Nov 13, 2023; 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.