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

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Independent Duty Corpsman Providers

NPI Name Type Address

1306167366

IDC Jason Seeforth

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1245542364

SFIDC Kimberly Leeniese Chavez

Individual

2450 Craven St

Branch Medical Clinic Naval Station Bldg 3300

San Diego, CA

1912219791

MR. IDC Salvador Alindada Vallebo JR.

Individual

7914 Gaylen Rd

San Diego, CA

1518270289

IDC Erik Brandon Saunders

Individual

34101 Farenholt Ave

Bldg 14

San Diego, CA

1295040426

Linda Anona Farmer

Individual

Bldg 601 Mccain Blvd Bmc Naval Base Coronado

San Diego, CA

1104131077

MR. IDC Edgar M. Santiago

Individual

Surface Warfare Medicine Inst

34101 Farenholt Ave

San Diego, CA

1154637759

MR. Geoffrey Winston Busscher

Individual

Expeditionary Health Services Bldg 116

3985 Cummings Rd. Suite 4

San Diego, CA

1104134006

MR. INDEPENDENT DUTY HM Andy Burnett

Individual

17144 Ruette Campana

San Diego, CA

1871781294

IDC Douglas Matthew Mclaughlin

Individual

Dry Side 32nd Street Naval Base Bldg 3300

San Diego, CA

1336117258

Kelly A Campbell

Individual

34101 Farenholt Ave

Bldg 14 Rm 230

San Diego, CA

1255392874

MR. HMC, IDC, USN James Steven Carbone

Individual

Surface Warfare Medical Institute

34101 Farenholt Ave

San Diego, CA

1821189499

IDC Robert W Gorman Balasco

Individual

Naval Medical Ctr

34800 Bob Wilson Drive

San Diego, CA

1194020693

USN/IDC Joe A Powell

Individual

3502 Attu Rd Bldg 326

San Diego, CA

1285931741

MR. IDC Joshua Roman Smith

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1194022665

IDC Mathieu Wilson Huovinen

Individual

3958 Iowa St Unit 5

San Diego, CA

1457658924

Angel Omar Vicente

Individual

34101 Farenholt Ave

Building #14

San Diego, CA

1710284286

Nathanael Lee Warren

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1083911556

MR. Ryan Matthew Irvine

Individual

34101 Farenholt Ave

Bldg 14, Idc

San Diego, CA

1518264084

Gregory L Hogue II

Individual

34101 Farenholt Ave

Bldg 14, Idc

San Diego, CA

1053618520

MR. Porfirio Nino

Individual

805 Beyer Way

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