Healthcare Provider Details

I. General information

NPI: 1134302805
Provider Name (Legal Business Name): US COAST GUARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USCG HQ COMDT (CG-1122),2100 SECOND ST SW
WASHINGTON DC
20593-0001
US

IV. Provider business mailing address

USCG HQ COMDT (CG-1122),2100 SECOND ST SW
WASHINGTON DC
20593-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-475-5181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE SANCHEZ
Title or Position: SENIOR MEDICAL OFFICER
Credential:
Phone: 707-765-7200