Organization
60TH MEDICAL GROUP SGSL
Active
Other names
TRAVIS BX OP PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
SKYMASTER BLVD BLDG 650 RM 149, TRAVIS AFB, CA 94535-1800
(707) 423-5345
(707) 423-7979
Mailing address
SKYMASTER BLVD BLDG 650 RM 149, TRAVIS AFB, CA 94535-1800
(707) 423-5345
(707) 423-7979
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2115819
PK
—
Enumeration date
09/22/2006
Last updated
01/21/2016
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