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

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Independent Duty Corpsman Providers

NPI Name Type Address

1912535493

IDC Michael Johnson

Individual

34101 Farenholt Ave

San Diego, CA

1508495482

Ricardo Rene Khaleel

Individual

34800 Bob Wilson Dr

San Diego, CA

1962031682

IDC Jacob Salinas

Individual

2575 Old Quarry Rd Apt 723

San Diego, CA

1013546548

IDC Brian George Nelson

Individual

34800 Bob Wilson Dr

San Diego, CA

1114546892

IDC Robert Dean Ficke

Individual

1281 9th Ave Unit 1714

San Diego, CA

1770102485

Robert Baca

Individual

34800 Bob Wilson Dr

San Diego, CA

1124647896

Merle Frederick Swenson

Individual

34800 Bob Wilson Dr

San Diego, CA

1275152654

IDC Kenneth Edward Siebert JR.

Individual

4831 Shields St

San Diego, CA

1255950630

Manuela Gabriela Delva

Individual

34800 Bob Wilson Dr

San Diego, CA

1508485996

Christopher Warren Samples

Individual

34800 Bob Wilson Dr

San Diego, CA

1295355246

IDC Nathan Eli Wagner

Individual

34800 Bob Wilson Dr

San Diego, CA

1154941995

SFIDC Joseph Dinar Brian Maneja Malabanan

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1992326854

Brandon Ponder

Individual

34101 Farenholt Ave

San Diego, CA

1144860990

Jose Luis Pina

Individual

140 Sylvester Rd

San Diego, CA

1497196315

MR. James Percy Mchale III

Individual

34800 Bob Wilson Dr

San Diego, CA

1730701293

MR. Conner Paul Spuhl

Individual

10071 Rio San Diego Dr Apt 311

San Diego, CA

1154943413

IDC Mark M Garcia

Individual

34800 Bob Wilson Dr

San Diego, CA

1114549474

Maximo Javier Diaz-rolon

Individual

34800 Bob Wilson Dr

San Diego, CA

1417570037

Nicholas Edward Brooky

Individual

34800 Bob Wilson Dr

San Diego, CA

1730702531

IDC Keith Michael Adams

Individual

34101 Farenholt Ave # 14

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