# 60TH MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104925585
- **Authorized official:** MARCOS LOPEZ (CLINICAL PHARMACIST)
- **Authorized official phone:** (707) 423-3459

## Contact information

- **Practice address:** 101 BODIN CIR, TRAVIS AFB, CA 94535-1809
- **Practice address phone:** (707) 423-3459
- **Mailing address:** 2569 SHOREY WAY, FAIRFIELD, CA 94533-6562
- **Mailing address phone:** (707) 423-6459

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | 4679 | PR | Yes |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 06/13/2008