Organization
U.S. COAST GUARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERRY RODRIGUEZ (CLINIC ADMINISTRATOR)
(619) 524-5204
Entity
Organization
Contact information
Practice address
2734 BELKNAP WAY, SAN DIEGO, CA 92106-6401
(619) 944-4859
Mailing address
2734 BELKNAP WAY, SAN DIEGO, CA 92106-6401
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Enumeration date
01/30/2007
Last updated
08/22/2020
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