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

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Independent Duty Corpsman Providers

NPI Name Type Address

1437747748

IDC Ian Victor Bayne-campbell

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1205424223

Raphael Luke Landicho

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1124618004

MR. IDC Christopher Brian Hilliard

Individual

34800 Bob Wilson Dr

San Diego, CA

1124619861

IDC STUDENT Keoky Delapena

Individual

14101 Farenholt Avenue Bldg 14

San Diego, CA

1588255228

IDC Matthew D Welch

Individual

34101 Farenholt Ave

San Diego, CA

1740871482

Nichole Gatlin

Individual

34101 Farenholt Ave

San Diego, CA

1437740131

US NAVY HM IDC Joshua Isaac Lazenby

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1780928606

MS. IDC Laren Olivar

Individual

3380 Sturtevant St

San Diego, CA

1629440086

Sean Coffey

Individual

3815 3rd Ave Apt 23

San Diego, CA

1053994343

Joshua Tyler Mathis

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1225611437

MRS. Jennifer Eunhyea Gonyea

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1780274456

Tinsae Tekleab

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1831780543

Warren Daichi Hickman

Individual

34101 Fareholt Ave Building 14

San Diego, CA

1649576828

MR. IDC Jorge L Acosta

Individual

34101 Farenholt Ave Ste 233

San Diego, CA

1588270326

IDC Angelina Yvette Harris

Individual

34800 Bob Wilson Dr

San Diego, CA

1760072581

STUDENT Aaron Joseph Pfrimmer

Individual

34101 Farenholt Ave Bldg 14

San Diego, CA

1124605068

Fletcher Lukens

Individual

34800 Bob Wilson Dr

San Diego, CA

1871170738

Adrian S Calma

Individual

5448 Santa Alicia

San Diego, CA

1053994327

Jake Garrett Theobald

Individual

34101 Farenholt Ave

San Diego, CA

1881277192

IDC Brandon Lane Thiele

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