Taxonomy Code 1710I1002X(1710i1002x)
Independent Duty Corpsman. Providers: 760

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Independent Duty Corpsman Providers

NPI Name Type Address

1366835696

Ronald Tinio

Individual

34101 Farenholt Ave

Bldg 14

San Diego, CA

1629462304

Juan Galarza

Individual

3425 Beech St

Apt 21

San Diego, CA

1659766822

Tara Bonilla

Individual

34800 Bob Wilson Dr

San Diego, CA

1174918106

MR. IDC Nicholas A. Sleeman

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1346636321

Jason Fout

Individual

34101 Farenholt Ave

Building 14

San Diego, CA

1588050306

IDC Lael Fernandez JR.

Individual

34101 Farenholt Ave

San Diego, CA

1659767390

MR. Alan Kenneth Sweat

Individual

34101 Farenholt Ave

San Diego, CA

1194111690

IDC Christina Shea

Individual

34800 Bob Wilson Dr

San Diego, CA

1730575028

MR. IDC Jimmy L Young JR.

Individual

34101 Farenholt Ave

San Diego, CA

1063808228

MR. IDC Kaleb Hart

Individual

34800 Bob Wilson Dr

San Diego, CA

1972999134

IDC Tramell Comfort

Individual

34800 Bob Wilson Dr

San Diego, CA

1508252768

IDC Morty Morris Ervin JR.

Individual

34800 Bob Wilson Dr

San Diego, CA

1598151755

Brian Crockett

Individual

34800 Bob Wilson Dr

San Diego, CA

1134515398

IDC Brandon Girard

Individual

34800 Bob Wilson Dr

San Diego, CA

1972999183

Justin Paul Lachney

Individual

34101 Farenholt Avenue

San Diego, CA

1578959706

IDC Cynthia Martens

Individual

34101 Farenholt Ave

Building 14

San Diego, CA

1285020354

IDC Carrie Conn

Individual

4981 Catoctin Dr Apt 6

San Diego, CA

1881072726

MR. DIVE IDC Benjamin Puckett

Individual

2661 A St

San Diego, CA

1669850145

Tamia Daniels

Individual

38400 Bob Wilson Dr

San Diego, CA

1023312725

MR. IDC Joseph E Lanyon

Individual

Naval Medical Center San Diego

Military Health Center

San Diego, CA

How to obtain, renew, or terminate an NPI

Every health care provider, whether it’s a hospital, pharmacy, or individual specialist, must obtain their own NPI number. This identification number is unique and is assigned upon application. In tod...

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Taxonomy Code 1710I1002X
Specialization Independent Duty Corpsman
Display Name Independent Duty Corpsman
Taxonomy Group Other Service Providers
Taxonomy Classification Military Health Care Provider
Definition A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Effective Date September 30, 2009
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Military Health Care Provider Codes

Independent Duty Medical Technicians

1710I1003X • providers: 1,299

Military Health Care Provider

171000000X • providers: 1,689