NPIMap

Organization Active NPI

Branch Medical Clinic Nalf San Clemente Island

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • San Clemente, CA
National Provider Identifier
1801288634
Registry record updated Nov 24, 2017
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 NALF SAN CLEMENTE ISLAND
Practice address
Wilson Cove
BLDG 60126
San Clemente, CA 92135
Phone
(619) 524-9356
NPI assigned
Mar 3, 2015
Last updated
Nov 24, 2017By 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 Nov 24, 2017

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

Authorized official

Name
William M Condon
Title
Bumed Ubo
Phone
(240) 401-3643

Specialties & licenses 1

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

Addresses

Primary practice location

Wilson Cove
BLDG 60126
San Clemente, CA 92135

Mailing address

Wilson Cove
BLDG 60126
San Clemente, CA 92135
Phone (619) 524-9356

National Provider Directory

National Provider Directory
Tax ID family
Tricare Outpatient Clinic Clairemont26 organizations share this tax ID, including this one
Part of
Tricare Outpatient Clinic Clairemont

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511481600000",
    "number": "1801288634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WILSON COVE",
            "address_2": "BLDG 60126",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92135",
            "telephone_number": "619-524-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WILSON COVE",
            "address_2": "BLDG 60126",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92135",
            "telephone_number": "619-524-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH MEDICAL CLINIC NALF SAN CLEMENTE ISLAND",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL MEDICAL CENTER SAN DIEGO",
        "enumeration_date": "2015-03-03",
        "last_updated": "2017-11-24",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUMED UBO",
        "authorized_official_telephone_number": "240-401-3643"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2017; 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.