Healthcare Provider Details

I. General information

NPI: 1427349760
Provider Name (Legal Business Name): NAVY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 04/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10666 N TORREY PINES RD # 403C
LA JOLLA CA
92037-1027
US

IV. Provider business mailing address

10666 N TORREY PINES RD # 403C
LA JOLLA CA
92037-1027
US

V. Phone/Fax

Practice location:
  • Phone: 858-554-3234
  • Fax: 858-554-3232
Mailing address:
  • Phone: 858-554-3234
  • Fax: 858-554-3232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICIA PEPPER
Title or Position: PROGRAM DIRECTOR
Credential: MD
Phone: 619-532-7936