Organization
NAVAL MEDICAL CENTER SAN DIEGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY MONCADA JUAN (INDEPENDENT DUTY CORPSMAN)
(760) 468-6860
Entity
Organization
Contact information
Practice address
35000 GUADALCANAL AVE, BLDG 596, SAN DIEGO, CA 92140
(619) 524-5196
Mailing address
605 D STREET, NATIONAL CITY, CA 91950
(760) 468-6860
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A7948523
DRIVER'S LICENSE
CA
Enumeration date
11/06/2012
Last updated
11/06/2012
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