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

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Independent Duty Corpsman Providers

NPI Name Type Address

1043424617

SURFACE IDC Paul James Leners

Individual

3455 Sturtevant St Ste 1

San Diego, CA

1962614560

IDC (NAVY) George Thomas Stevens IV

Individual

3330 Tarawa Rd Bldg 327

San Diego, CA

1689896995

MR. IDC Matthew James Schaffer

Individual

34101 Farenholt Ave

San Diego, CA

1164637005

MR. IDC, RN Preston P. Thrift

Individual

53560 Hull St

San Diego, CA

1568675528

MR. Michael Francis Mccune

Individual

34101 Farenholt Ave.idc Suite

San Diego, CA

1063627099

MS. IDC Connie Jean Lawson

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1659587871

MR. IDC Tavis Scott Buckingham

Individual

Uss New Orleans (lpd 18) Fpo Ap 96673-1701

Commanding Officer

San Diego, CA

1316153232

NAVY SFIDC Jeffrey Lane Jones

Individual

3226 Tarawa Rd

San Diego, CA

1053529578

US NAVY IDC Robert Claire Goodrich

Individual

34101 Farenholt Ave

San Diego, CA

1346450665

MR. SFIDC Isaias C Suarez II

Individual

3325 Senn Rd

Bldg 55 Rm 228

San Diego, CA

1982805727

IDC James Francis Ward

Individual

34101 Farenholt Ave

San Diego, CA

1457554651

MR. IDC Edward Hourican

Individual

3325 Senn Rd

San Diego, CA

1588854368

MR. IDC Eduardo Malayao Magpayo

Individual

35000 Guadalcanal Ave

San Diego, CA

1851587075

MR. IDC Timothy Wayne Sefa

Individual

35000 Guadalcanal Ave

San Diego, CA

1639367345

Tracie L Ham

Individual

34800 Bob Wilson Dr

San Diego, CA

1790967255

MR. NAVY IDC Sean Edward Snook

Individual

3985 Cummings Rd Ste 4

Bldg 116

San Diego, CA

1588846059

MR. Christopher Proctor

Individual

3985 Cummings Rd Ste 4

Bld 116

San Diego, CA

1336322940

MS. IDC Claudia Yvette Islas

Individual

34800 Bob Wilson Dr

San Diego, CA

1093912149

MR. IDC Christopher Douglas Kotz

Individual

3325 Senn Rd

Building 55, Room 225

San Diego, CA

1821273814

IDC Jeramy Paul Henson

Individual

3325 Senn Rd Ste 7

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