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Individual
BENJAMIN JACOB GOMEZ
Active
Individual
BENJAMIN JACOB GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
NULL
1710I1002X
Independent Duty Corpsman
Primary
—
NULL
1710I1002X
Independent Duty Corpsman
Primary
—
—
1710I1003X
Independent Duty Medical Technicians
—
NULL
261QM1102X
Military Outpatient Operational (Transportable) Component Clinic/Center
—
NULL
261QM1103X
Military Ambulatory Procedure Visits Operational (Transportable) Clinic/Center
—
NULL
286500000X
Military Hospital
—
NULL
Other
Enumeration date
09/05/2019
Last updated
12/17/2019
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