San DG San Clemente Phcy

Primary specialty

Military/U.S. Coast Guard PharmacyTaxonomy code 332000000X

Legal business name

SAN DG SAN CLEMENTE PHCY

Practice address

Branch Medical Clinic
BLDG 60126
San Clemente Island, CA 92135

Phone

(619) 524-9356

NPI assigned

Jul 13, 2007

Last updated

Jul 13, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Hector Morales

Title

Manager Dod Pharmacy Operations Cen

Phone

(210) 221-8443

Specialties & licenses 1

Addresses

Tax ID family

Naval Medical Center San Diego2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Naval Medical Center San Diego

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1366527764
  NPD tax ID

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1578762175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 STANLEY RD",
            "address_2": "SUITE 208",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347510",
            "telephone_number": "210-221-8274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BRANCH MEDICAL CLINIC",
            "address_2": "BLDG 60126",
            "city": "SAN CLEMENTE ISLAND",
            "state": "CA",
            "postal_code": "92135",
            "telephone_number": "619-524-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DG SAN CLEMENTE PHCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_title_or_position": "MANAGER DOD PHARMACY OPERATIONS CEN",
        "authorized_official_telephone_number": "210-221-8443",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332000000X",
            "taxonomy_group": "",
            "desc": "Military/U.S. Coast Guard Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.