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

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Independent Duty Corpsman Providers

NPI Name Type Address

1952608424

IDC Eric Lee Poston

Individual

34101 Farenholt Ave

Bldg 14, Idc

San Diego, CA

1023315595

MR. IDC Andrew Bud Taylor

Individual

34101 Farenholt Ave

Bldg 14

San Diego, CA

1508163718

MR. Stephen Anthony Caponey

Individual

24101 Farenholt Ave Bldg 14

San Diego, CA

1578861324

IDC Edward William Scheinert

Individual

2424 Rendova Rd Suite 156

Nswg-1 Logsuppu

San Diego, CA

1508164278

MR. IDC Peter Soriben Quejado II

Individual

Swmi

34101 Farenholt Ave

San Diego, CA

1154629335

IDC Phirum Peter Sary

Individual

34101 Farenholt Ave

San Diego, CA

1558651711

MR. DIVE IDC Tristan David Cavender

Individual

915 57th St

San Diego, CA

1588623490

Edward A Miller JR.

Individual

Bldg 497 Moffett Rd

Deep Submergence Unit

San Diego, CA

1750674818

IDC Trinidad Alcantara Alvarenga

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1770877136

United States Navy

Organization

34101 Farenholt Ave

Building 14

San Diego, CA

1508150574

IDC Francis Michael Nicola

Individual

34800 Bob Wilson Dr

San Diego, CA

1659666329

IDC Francis Asuncion

Individual

Nshs 34101 Farenholt Ave

San Diego, CA

1568757235

IDC John Paul Turbeville

Individual

34101 Farenholt Ave

San Diego, CA

1194010868

IDC Alfredo Andres Medina

Individual

34101 Farenholt Ave

San Diego, CA

1003101775

IDC Christopher A Wallace

Individual

34101 Farenholt Ave

San Diego, CA

1467747139

John Ray Hanson

Individual

34101 Farenholt Ave

San Diego, CA

1326333683

IDC Guadalupe Martinez III

Individual

Naval School Of Health Sciences

34101 Farenholt Ave

San Diego, CA

1750676938

MR. Joseph Michael Childers

Individual

Seal Team Three Medical

2642 Trident Way

San Diego, CA

1699061200

Sally Roseanne Durant

Individual

2051 Cushing Rd

San Diego, CA

1962798553

IDC Mahtob Mae Johnson

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