Healthcare Provider Details

I. General information

NPI: 1821471467
Provider Name (Legal Business Name): PATRICK ENGELBERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 02/09/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DRIVE NAVAL MEDICAL CTR
SAN DIEGO CA
92134
US

IV. Provider business mailing address

34800 BOB WILSON DRIVE NAVAL MEDICAL CTR
SAN DIEGO CA
92134
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-8547
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD90847
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101260801
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: