Healthcare Provider Details

I. General information

NPI: 1386604387
Provider Name (Legal Business Name): NH CAMP PENDLETON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MERCY CIRCLE FIN MGMT CODE 0814
CAMP PENDLETON CA
92055-5191
US

IV. Provider business mailing address

PO BOX 555191
CAMP PENDLETON CA
92055-5191
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-1621
  • Fax: 760-725-1661
Mailing address:
  • Phone: 760-725-1621
  • Fax: 760-725-1661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: TIER ARNOLD
Title or Position: UBO MANAGER
Credential:
Phone: 760-719-3920