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Organization

TRICARE OUTPATIENT CLINIC CHULA VISTA

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
644 NAPLES ST, CHULA VISTA, CA 91911-1636
(619) 744-5354
(619) 744-5391
Mailing address
34520 BOB WILSON DR, SAN DIEGO, CA 92134-2098
(619) 532-6636
(619) 532-6645

Taxonomy

Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary

Other

Enumeration date
08/13/2007
Last updated
04/04/2019
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