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

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Independent Duty Corpsman Providers

NPI Name Type Address

1184095655

Jerome Ramsey

Individual

2534 Trident Way

San Diego, CA

1780056267

MR. SFIDC David Alexander Hinton

Individual

2632 A St

None

San Diego, CA

1801268263

MR. SFIDC Eric Carl Scholander

Individual

6634 Antigua Blvd

San Diego, CA

1437521895

IDC Benjamin Graham

Individual

10164 Glennon St

San Diego, CA

1346612702

MR. SFIDC Michael Blake Collins

Individual

10255 Laffey Ct

San Diego, CA

1679945034

MR. Alexandru Agiu

Individual

34800 Bob Wilson Dr

San Diego, CA

1740652122

Joshua David Thornbloom

Individual

3229 Bebas Ln

San Diego, CA

1508231606

IDC Durell Jacobs

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1689046047

MR. Brett Allen Boland

Individual

34800 Bob Wilson Dr

San Diego, CA

1831554336

IDC Brandon Elrod

Individual

34101 Farenholt Ave

Building 14

San Diego, CA

1811354061

MR. IDC Shawn Stone

Individual

3956 Texas St Unit 15

San Diego, CA

1124236898

IDC David Paul Maggio

Individual

Naval Special Warfare Command

2000 Trident Way

San Diego, CA

1679931299

IDC Marios Potamitis

Individual

2195 Station Village Way

Apartment #1406

San Diego, CA

1164882767

Joshua Cabrera

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1134580913

MR. IDC Emilio Casenave

Individual

6031 Sandy Shore Ct

San Diego, CA

1861854614

MR. IDC Steven Jacko

Individual

34101 Farenholt Ave

San Diego, CA

1205298510

Joeben Estacio

Individual

1440 Hotel Circle N Apt 212

San Diego, CA

1922343151

MR. IDC Allen Joseph Neese

Individual

34101 Farenholt Ave

Building 14

San Diego, CA

1366805665

DIVE IDC Garrett Herlindo Castro

Individual

2930 Tarawa Rd

San Diego, CA

1215383211

IDC Ricardo Andres Chanes

Individual

3860 Haines St Apt K

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