NPIMap

Organization Active NPI

Branch Medical Clinic MCRD

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • San Diego, CA
National Provider Identifier
1649446857
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
BRANCH MEDICAL CLINIC MCRD
Practice address
35000 Guadalcanal St
Branch Medical Clinic MCRD
San Diego, CA 92140
Phone
(619) 524-4102
NPI assigned
May 7, 2008
Last updated
Apr 4, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
NAVAL MEDICAL CENTER SAN DIEGOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Authorized official

Name
Mr. William M Condon
Title
Navy Medicine Ubo Program Manager
Phone
(240) 401-3643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X Primary

Addresses

Primary practice location

35000 Guadalcanal St
Branch Medical Clinic MCRD
San Diego, CA 92140

Mailing address

35000 Guadalcanal St
BMC MCRD
San Diego, CA 92145
Phone (619) 524-4045

National Provider Directory

National Provider Directory
Tax ID family
Branch Dental Clinic Sub Base San Diego26 organizations share this tax ID, including this one
Part of
Branch Dental Clinic Sub Base San Diego

Other organizations with this tax ID 25

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

View all 25

Locations

35000 Guadalcanal St
San Diego, CA 92140
Phone (619) 524-4045

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1649446857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35000 GUADALCANAL ST",
            "address_2": "BMC MCRD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92145",
            "telephone_number": "619-524-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35000 GUADALCANAL ST",
            "address_2": "BRANCH MEDICAL CLINIC MCRD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92140",
            "telephone_number": "619-524-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH MEDICAL CLINIC MCRD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL MEDICAL CENTER SAN DIEGO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "NAVY MEDICINE UBO PROGRAM MANAGER",
        "authorized_official_telephone_number": "240-401-3643",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "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 Apr 4, 2019; 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.