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

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Independent Duty Corpsman Providers

NPI Name Type Address

1518118546

I.D.C Estrellita Delrosar Edmond

Individual

2450 Craven St

San Diego, CA

1518458777

IDC Douangta Yang

Individual

Comlcsron One 3325 Senn Rd Suite 7

San Diego, CA

1275026999

USN DIVE IDC Vladimir Link

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1578056982

IDC Daniel Keith Zihlman

Individual

34101 Farenholt Ave

San Diego, CA

1003309410

MR. IDC Gabriel Jose San Pedro

Individual

34101 Farenholt Ave

San Diego, CA

1043606205

MR. IDC J William Kirk

Individual

34101 Farenholt Ave

San Diego, CA

1346733755

IDC Jacob A Jeffreys

Individual

2994 B St

San Diego, CA

1942793369

Jose E Gonzalez-ramos

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1396238713

INDEPENDENT DUTY COR Phillip Daniel Morris

Individual

34800 Bob Wilson Dr

San Diego, CA

1568955987

Luis Javier Esquivel

Individual

34101 Fareholt Ave

San Diego, CA

1144713595

SURFACE FORCE IDC Daniel Scott Langhorne

Individual

34101 Farenholt Ave

San Diego, CA

1023501301

Jared Michael O'brien

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1982197232

Jamarh Dixon

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1194218321

Gilbert Flores

Individual

14, 34101 Farenholt Ave

San Diego, CA

1912492950

Francis Allen Boecker

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1407341639

DEEP SEA IDC Bradford Joshua Allison

Individual

34101 Farenholt Ave

San Diego, CA

1174019046

DIVE IDC Nolan Andrew Ellis

Individual

3156 Salmon St

San Diego, CA

1255827010

IDC Jacob Meers

Individual

34101 Farenholt Ave

San Diego, CA

1164918926

MR. SFIDC Anthony William Reynolds JR.

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1861988628

IDC Jeffrey White

Individual

3401 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