# US COAST GUARD

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

## Provider details

- **NPI number:** 1538480298
- **Authorized official:** MRS. NAOMI DENNIS (HSC/ CLINIC ADMINISTRATOR)
- **Authorized official phone:** (619) 524-5204

## Contact information

- **Practice address:** 2051 CUSHING ROAD, US COAST GUARD, SAN DIEGO, CA 92106
- **Practice address phone:** (619) 524-5204
- **Practice address fax:** (619) 524-4459
- **Mailing address:** 2051 CUSHING ROAD, US COAST GUARD, SAN DIEGO, CA 92106
- **Mailing address phone:** (619) 524-5204
- **Mailing address fax:** (619) 524-4459

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | 0101056076 | VA | Yes |

## Other

- **Enumeration date:** 06/17/2010
- **Last updated:** 06/17/2010