NPIMap

Organization Active NPI

Branch Medical Clinic El Centro

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • El Centro, CA
National Provider Identifier
1841482841
Registry record updated Mar 7, 2023
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 EL CENTRO
Practice address
Naval Branch Health Clinic
Naval Air Facility BLDG 523
El Centro, CA 92243
Phone
(760) 339-2674
Fax
(760) 339-2661
NPI assigned
Aug 14, 2007
Last updated
Mar 7, 2023By 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 Mar 7, 2023

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

Authorized official

Name
Mr. William Michael 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

Naval Branch Health Clinic
Naval Air Facility BLDG 523
El Centro, CA 92243

Mailing address

34520 Bob Wilson Dr
San Diego, CA 92134-2098
Phone (619) 532-6636

Other identifiers 4

IdentifierTypeStateIssuer
05-20862OtherCANCPDP
05022FOtherCAMEDICARE
HSP63228FMedicaidCA
ZZT23228FMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Branch Medical Clinic Nalf San Clemente Island26 organizations share this tax ID, including this one
Part of
Branch Medical Clinic Nalf San Clemente Island

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": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1841482841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34520 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921342098",
            "telephone_number": "619-532-6636",
            "fax_number": "619-532-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL BRANCH HEALTH CLINIC",
            "address_2": "NAVAL AIR FACILITY BLDG 523",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "92243",
            "telephone_number": "760-339-2674",
            "fax_number": "760-339-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH MEDICAL CLINIC EL CENTRO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL MEDICAL CENTER SAN DIEGO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MICHAEL",
        "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "05-20862",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "05022F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP63228F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT23228F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.