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Organization
UNITED STATES NAVY
Active
Organization
UNITED STATES NAVY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER RUOCCO (COMMANDING OFFICER)
(760) 725-5208
Entity
Organization
Contact information
Practice address
BUILDING H 2005 KNIGHT LANE, NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS, JACKSONVILLE, FL 32212-0140
(760) 725-3213
Mailing address
853 VALLEY AVE, SOLANA BEACH, CA 92075-2492
(631) 948-3006
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7136-15
WI
Other
Enumeration date
10/03/2016
Last updated
10/03/2016
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