Healthcare Provider Details

I. General information

NPI: 1841603248
Provider Name (Legal Business Name): NAVAL HOSPITAL CAMP PENDLETON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BRANCH MEDICAL CLINIC NAF BLDG 23
EL CENTRO 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: 760-725-7918
  • Fax: 760-725-1461
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