# U.S. COAST GUARD

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

## Provider details

- **NPI number:** 1104962448
- **Authorized official:** GERRY RODRIGUEZ (CLINIC ADMINISTRATOR)
- **Authorized official phone:** (619) 524-5204

## Contact information

- **Practice address:** 2734 BELKNAP WAY, SAN DIEGO, CA 92106-6401
- **Practice address phone:** (619) 944-4859
- **Mailing address:** 2734 BELKNAP WAY, SAN DIEGO, CA 92106-6401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/30/2007
- **Last updated:** 08/22/2020