# BRANCH MEDICAL CLINIC EASTLAKE

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

## Provider details

- **NPI number:** 1568865319
- **Legal business name:** NAVAL MEDICAL CENTER SAN DIEGO
- **Authorized official:** WILLIAM M CONDON (BUMED UBO)
- **Authorized official phone:** (240) 401-3643

## Contact information

- **Practice address:** 2300 BOSWELL RD, SUITE 190, CHULA VISTA, CA 91914-3523
- **Practice address phone:** (619) 744-5355
- **Mailing address:** 2300 BOSWELL RD, SUITE 190, CHULA VISTA, CA 91914-3523
- **Mailing address phone:** (619) 744-5355

## Taxonomy

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

## Other

- **Enumeration date:** 10/07/2014
- **Last updated:** 11/24/2017