Healthcare Provider Details

I. General information

NPI: 1821197872
Provider Name (Legal Business Name): NMC SAN DIEGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLDG 601
SAN DIEGO CA
92135
US

IV. Provider business mailing address

BLDG 601
SAN DIEGO CA
92135
US

V. Phone/Fax

Practice location:
  • Phone: 619-545-4290
  • Fax: 619-532-5898
Mailing address:
  • Phone: 619-545-4290
  • Fax: 619-532-5898

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