Organization
BRANCH MEDICAL CLINIC NAVAL STATION SAN DIEGO
Active
Parent organization
NAVAL MEDICAL CENTER SAN DIEGO
Organization subpart
Yes
Provider details
NPI number
Legal business name
NAVAL MEDICAL CENTER SAN DIEGO
Authorized official
MR. WILLIAM MICHAEL CONDON (NAVY MEDICINE UBO PROGRAM MANAGER)
(240) 401-3643
Entity
Organization
Contact information
Practice address
2450 CRAVEN STEET, SAN DIEGO, CA 92136-5599
(619) 556-6302
(619) 556-9419
Mailing address
2450 CRAVEN ST, SAN DIEGO, CA 92136-5599
(619) 556-6302
(619) 556-9419
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HSP63228F
—
CA
Enumeration date
07/30/2007
Last updated
04/04/2019
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