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

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Independent Duty Corpsman Providers

NPI Name Type Address

1619411048

David Leyva

Individual

34101 Farenholt Ave

Bldg 15

San Diego, CA

1255701678

Stephanie Fanchiang

Individual

34101 Farenholt Ave

San Diego, CA

1609246636

Matthew Garcia

Individual

1440 Hotel Cir N Apt 122

San Diego, CA

1548705411

MR. Alexander Naval

Individual

94010 Farenholt Ave

San Diego, CA

1932531282

MR. I.D.C Stephen Sevier

Individual

10186 Bausell Ct

San Diego, CA

1144767666

MR. Dennis James Anderson

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1639571359

MR. IDC Kevin Gooch

Individual

4221 34th St

Apt #25

San Diego, CA

1548702558

Jason Hancock

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1396277166

IDC Allan Nelson Ganuza

Individual

34800 Bob Wilson Dr

Naval Medical Center San Diego

San Diego, CA

1427583947

IDC Patrick Mctavish

Individual

3781 Atlas St

San Diego, CA

1497280929

IDC Joseph Roman Shields

Individual

3166 Barnett Ave

San Diego, CA

1386179810

IDC Titus Luke Baker

Individual

2695 Shoup Dr

San Diego, CA

1629503156

IDC Quintin Bright

Individual

3443 Kearny Villa Ln

San Diego, CA

1609301134

IDC Chase Speed

Individual

1440 Hotel Cir N

Apt 467

San Diego, CA

1457886178

Lewis James Lasauskas

Individual

34101 Farenholt Ave

Building 14

San Diego, CA

1871013417

Garion Pequeno

Individual

14 Farenholt Ave

San Diego, CA

1326563982

IDC Tommy Lee Turtle

Individual

34101 Farenholt Ave

Building 14

San Diego, CA

1588180913

IDC Jon French

Individual

34101 Farenholt Ave

San Diego, CA

1285150383

Devin Michael Miller

Individual

34101 Farenholt Ave

San Diego, CA

1427575349

MR. IDC David Tyler Bauer

Individual

34101 Farenholt Ave

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