Organization
US COAST GUARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NAOMI DENNIS (HSC/ CLINIC ADMINISTRATOR)
(619) 524-5204
Entity
Organization
Contact information
Practice address
2051 CUSHING ROAD, US COAST GUARD, SAN DIEGO, CA 92106
(619) 524-5204
(619) 524-4459
Mailing address
2051 CUSHING ROAD, US COAST GUARD, SAN DIEGO, CA 92106
(619) 524-5204
(619) 524-4459
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
0101056076
VA
Other
Enumeration date
06/17/2010
Last updated
06/17/2010
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