# TRICARE OUTPATIENT CLINIC CHULA VISTA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NAVAL MEDICAL CENTER SAN DIEGO
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1467644625
- **Legal business name:** NAVAL MEDICAL CENTER SAN DIEGO
- **Authorized official:** MR. WILLIAM MICHAEL CONDON (NAVY MEDICINE UBO PROGRAM MANAGER)
- **Authorized official phone:** (240) 401-3643

## Contact information

- **Practice address:** 644 NAPLES ST, CHULA VISTA, CA 91911-1636
- **Practice address phone:** (619) 744-5354
- **Practice address fax:** (619) 744-5391
- **Mailing address:** 34520 BOB WILSON DR, SAN DIEGO, CA 92134-2098
- **Mailing address phone:** (619) 532-6636
- **Mailing address fax:** (619) 532-6645

## Taxonomy

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

## Other

- **Enumeration date:** 08/13/2007
- **Last updated:** 04/04/2019