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

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Independent Duty Corpsman Providers

NPI Name Type Address

1407359763

MR. SFIDC Frederick Roy Novella

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1316440670

IDC Michael Anthony Anderson

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1952804213

SF IDC Brandon Earl Burke

Individual

34101 Farenholt Ave

San Diego, CA

1124521489

SF IDC Leah Scott

Individual

34101 Farenholt Ave

San Diego, CA

1669975926

James Michael Miskimen

Individual

34101 Farenholt Ave

San Diego, CA

1427551795

Sean Ian Mckinney

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1093218109

MR. SFIDC Tam D Nguyen

Individual

34101 Farenholt Ave

San Diego, CA

1003319120

Alexander Box

Individual

34101 Farenholt Ave

San Diego, CA

1093218117

IDC Luke Andrew Austin

Individual

34101 Farenholt Ave

San Diego, CA

1013410141

MR. SFIDC Steven R Currier JR.

Individual

34101 Farenholt Ave

San Diego, CA

1114217627

IDC Christopher Wayne Swinney

Individual

3401 Farenholt Ave

San Diego, CA

1902238579

SFIDC Ryan James Gordon

Individual

9955 Pomerado Rd Bldg 20300

San Diego, CA

1053815381

IDC Alicia R Turner

Individual

34101 Farenholt Ave

San Diego, CA

1902300254

Jose Gonzalez

Individual

34800 Bob Wilson Dr

San Diego, CA

1285131425

IDC Patrick John Charbonneau

Individual

34101 Farenholt Ave

San Diego, CA

1083111223

MR. IDC Joshua Dewayne Allard

Individual

34101 Farenholt Ave

San Diego, CA

1821585332

IDC Dejanae Hairston

Individual

34800 Bob Wilson Drive

San Diego, CA

1255828646

IDC Martina Jones Maddox

Individual

857 16th St

San Diego, CA

1609365964

IDC Michael Delton Bryson JR.

Individual

Surface Warfare Medical Institute 34101 Farenholt Avenu

San Diego, CA

1275022386

MR. IDC Dionicio Dale Brown

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