Healthcare Provider Details

I. General information

NPI: 1245645480
Provider Name (Legal Business Name): NAVAL HOSPITAL CAMP PENDLETON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 07/06/2026
Certification Date: 03/08/2023
Deactivation Date: 05/29/2025
Reactivation Date: 07/06/2026

III. Provider practice location address

22 AREA BRANCH MEDICAL CLINIC BLDG 22190
CAMP PENDLETON CA
92055
US

IV. Provider business mailing address

34520 BOB WILSON DR STE 20
SAN DIEGO CA
92134-2098
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-3784
  • Fax:
Mailing address:
  • Phone: 619-532-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332000000X
TaxonomyMilitary/U.S. Coast Guard Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. HECTOR MORALES
Title or Position: CHIEF DHA POSC
Credential:
Phone: 210-536-6650