Active NPI
Gilbert Corpuz, US NAVY IDC
- Independent Duty Corpsman
- San Diego, CA
National Provider Identifier
1750757134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Corpsman
- License
- 1750757134
- Practice address
- 34101 Farenholt Ave
Building 14
San Diego, CA 92134-7000 - Phone
- (619) 532-9428
- NPI assigned
- Aug 19, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intermediate Emergency Medical Technician | 146M00000X | US NAVY IDC | CA | |
| Other Technician | 247200000X | US NAVY IDC | CA | |
| Independent Duty Corpsman | 1710I1002X | 1750757134 | CA | Primary |
Addresses
Primary practice location
34101 Farenholt Ave
Building 14
San Diego, CA 92134-7000
Mailing address
PSC 819 Box 4340
Fpo, AE 09645-0044
Phone (001) 349-5682
Other practice location 1
PSC 819 Box 18
Fpo, AE 09645-0001
Phone (011) 349-5682 ext. 3513
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| US NAVY IDC | Other | CA | US NAVY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1750757134 | CA | MD | Independent Duty Corpsman |
| US NAVY IDC | CA | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642636800000",
"number": "1750757134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "PSC 819 BOX 4340",
"city": "FPO",
"state": "AE",
"postal_code": "096450044",
"telephone_number": "001-349-5682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34101 FARENHOLT AVE",
"address_2": "BUILDING 14",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921347000",
"telephone_number": "619-532-9428"
}
],
"practiceLocations": [
{
"address_1": "PSC 819 Box 18",
"address_purpose": "LOCATION",
"city": "FPO",
"state": "AE",
"postal_code": "096450001",
"country_code": "US",
"telephone_number": "011-349-5682 x3513",
"country_name": "United States",
"address_type": "MIL"
}
],
"basic": {
"last_name": "CORPUZ",
"first_name": "GILBERT",
"credential": "US NAVY IDC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-19",
"last_updated": "2022-01-20",
"certification_date": "2022-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "146M00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Intermediate",
"state": "CA",
"license": "US NAVY IDC",
"primary": false
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "CA",
"license": "US NAVY IDC",
"primary": false
},
{
"code": "1710I1002X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Corpsman",
"state": "CA",
"license": "1750757134",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US NAVY",
"identifier": "US NAVY IDC",
"state": "CA"
}
],
"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 Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.