Taxonomy Code 1710I1002X(1710i1002x)
Independent Duty Corpsman. Providers: 1,105

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Independent Duty Corpsman Providers

NPI Name Type Address

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

1629250519

IDC Tyson Earl Hensel

Individual

Mclb Barstow Bldg 17

Barstow, CA

1427231000

MR. IDC Adrian Leslie Robinson JR.

Individual

3500 Berkeley Court

B

Twentynine Palms, CA

1336322940

MS. IDC Claudia Yvette Islas

Individual

34800 Bob Wilson Dr

San Diego, CA

1467635797

IDC Roselyn Drapiza Ilanga

Individual

Marine Corps Air Ground Combat Center

Twentynine Palms, CA

1164606463

MR. IDC Philip A. Rice

Individual

Building 2000 Mcagcc

Clb-7 Bas

Twentynine Palms, CA

1700061322

MR. IDC Karlton James Bethea

Individual

249 E Upjohn Ave

Ridgecrest, CA

1891970026

IDC Michael Shannon Clifton

Individual

Nmcb 5

Unit 25294

Fpo Ap, 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

1629033907

MR. Morrell J Lavender

Individual

2650 Stockton Rd Bldg 624

Naval Training Center

San Diego, CA

1376751917

Michael Clark

Individual

140 Sylvester Rd

San Diego, CA

1255519773

MRS. Osvaldo Diaz

Individual

3d Battalion 1st Mar Battalion Aid Station

Box 555422

Camp Pendleton, CA

1568631539

NAVY IDC Juan Carlos Vazquez

Individual

3936 Baja Vista Dr

Oceanside, CA

1255500609

MR. Jesse John Tossetti

Individual

6591 49 Palms Ave

Twentynine Palms, CA

1689782294

I.D.C. Carlos Roberto Martinez

Individual

161 1st St

Bldg 1402

Port Hueneme, CA

1063682581

Ryan T De La Cruz

Individual

Nmcb - 3 Unit 25269 Fpo Ap 96601

Port Hueneme, CA

1235309758

IDC Allan Dinoso Felicano

Individual

Bldg 601 Mccaine Blvd

Branch Medical Clinic

San Diego, CA

1982875498

MR. IDC Allan B Navarro

Individual

2805 Via Diego

Carlsbad, 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