# UNITED STATES NAVY

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

## Provider details

- **NPI number:** 1295009728
- **Authorized official:** MR. EBEN ARTRURO SANCHEZ SURFACE IDC (IDC)
- **Authorized official phone:** (619) 925-0259

## Contact information

- **Practice address:** 667 ORANGEWOOD DR, VIRGINIA BEACH, VA 23453-2124
- **Practice address phone:** (619) 925-0259
- **Mailing address:** 667 ORANGEWOOD DR, VIRGINIA BEACH, VA 23453-2124
- **Mailing address phone:** (619) 925-0259

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1710I1002X | Independent Duty Corpsman | — | NULL | Yes |
| 1710I1002X | Independent Duty Corpsman | — | — | Yes |

## Other

- **Enumeration date:** 03/01/2012
- **Last updated:** 03/01/2012