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

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Independent Duty Corpsman Providers

NPI Name Type Address

1083815831

MR. Raymond Russell Beckley

Individual

240 Manzanilla Way

Oceanside, CA

1376754242

MR. SFIDC Joshua William Ross

Individual

Naval Ambulatory Care Clinic

162 1st Street Building 1402

Port Hueneme, CA

1558562645

MR. IDC Joshua Sandoval

Individual

Mag -39 Medical

Camp Pednlteon

Camp Pednleton, CA

1982805727

IDC James Francis Ward

Individual

34101 Farenholt Ave

San Diego, CA

1992909204

Kelly Marie Kendrick

Individual

Bldg 2161032 Marine Corps Base

Camp Pendleton, CA

1922209204

IDC Steven Lee Bledsoe

Individual

Clr-17 Ras, 1st Mlg

Bldg 14030

Camp Pendleton, CA

1710188875

SFIDC John C Garn

Individual

Naval Hospital Camp Pendleton

Box 555191

Camp Pendleton, CA

1457554651

MR. IDC Edward Hourican

Individual

3325 Senn Rd

San Diego, CA

1841498227

MS. IDC Kathleen L Pierce

Individual

937 Franklin Blvd

Lemoore, CA

1669677951

MRS. IDC Teresa Meisenhalder

Individual

1st Medical Battalion 22 Gas

Bldg 22190

Camp Pendleton, CA

1861697013

IDC Renato L Tolosa

Individual

1285 Lavender Ln

Hemet, CA

1780889584

MR. IDC Kirk William Stpierre

Individual

22 Area Group Aid Station

Camp Pendleton, CA

1023143575

IDC Michael S Jimenez

Individual

754 Rambur St

Chula Vista, CA

1588854368

MR. IDC Eduardo Malayao Magpayo

Individual

35000 Guadalcanal Ave

San Diego, CA

1396930129

Shawn Jeremy Kern

Individual

Underwater Construction Team 2 Medical

4643 Dock Road Bldg 524

Port Hueneme, CA

1851587075

MR. IDC Timothy Wayne Sefa

Individual

35000 Guadalcanal Ave

San Diego, CA

1437347317

MR. IDC/RN Leo Borisovich Bugaeff I

Individual

4643 Dock Rd Bldg 524

Port Hueneme, CA

1639367345

Tracie L Ham

Individual

34800 Bob Wilson Dr

San Diego, CA

1083803555

IDC James Carl Bedingfield

Individual

31 Area Branch Medical Clinic

Bldg. 310514

Camp Pendleton, CA

1831379130

IDC Richard Eduardo Mascioni

Individual

800 Seal Beach Blvd

#22

Seal Beach, 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