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

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Independent Duty Corpsman Providers

NPI Name Type Address

1811392715

IDC David Layne Rose

Individual

2531 Ridge View Dr

San Diego, CA

1447657002

Alexander P Haedo-gonzalez

Individual

4590 Zion Ave Apt 13

San Diego, CA

1619391356

MR. INDEPEDENT DUTY CORP Phillip Nafus

Individual

3685 Cummings Rd

San Diego, CA

1124425475

Michael Zuniga

Individual

34101 Farenholt Ave

San Diego, CA

1679971949

Kalin Verhelst

Individual

2282 Gill Village Way Apt 1210

San Diego, CA

1578961728

Bryan Allen

Individual

2006 Pelican Hill Rd

San Diego, CA

1750770962

Hakiem Clarkson

Individual

34800 Bob Wilson Dr

San Diego, CA

1316336258

MR. IDC Jorge E Talavera

Individual

3875 Florida St Apt 2

San Diego, CA

1871982694

Abraham Bakongo

Individual

34800 Bob Wilson Dr

San Diego, CA

1912396730

Ryan Hildebrandt

Individual

34800 Bob Wilson Dr

San Diego, CA

1164812186

IDC Thomas Daniel Lamb

Individual

8293 Jordan St

San Diego, CA

1619367455

Ryan Houtz

Individual

6748 Tuxedo Rd

San Diego, CA

1669862413

MR. IDC Derick Medina

Individual

34101 Farenholt Ave

San Diego, CA

1730570979

MR. OTHER Christopher Royalty

Individual

34800 Bob Wilson Dr

San Diego, CA

1215320536

Karla Reid

Individual

34101 Farenholt Ave

Building 14

San Diego, CA

1124411442

IDC USN Luis Armando Urbina

Individual

34101 Farenholt Ave

San Diego, CA

1568855880

Jameson Basa

Individual

1976 Sky Harbor Rd

San Diego, CA

1821481144

Juan Guillermo Hernandezgoll

Individual

34101 Farenholt Ave

Building 14

San Diego, CA

1730572058

Emmanuel Kaburi

Individual

34101 Farenholt Ave

Bldg 14

San Diego, CA

1285027516

Monique Brown

Individual

34101 Farenholt Ave

Bldg 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