# BENJAMIN JACOB GOMEZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1801445663
- **Gender:** Man
- **Credential:** IDC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171000000X | Military Health Care Provider | — | NULL | — |
| 1710I1002X | Independent Duty Corpsman | — | NULL | Yes |
| 1710I1002X | Independent Duty Corpsman | — | — | Yes |
| 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