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General NPI Number Information
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NPI Number | 1205896701
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Entity Type | Organization
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Legal Business Name | 60TH MEDGRP-TRAVIS
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 101 BODIN CIR 60TH MEDICAL GROUP
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City | TRAVIS AFB
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State | CA
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Zip | 94535-1809
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Country | US
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Telephone | 707-451-7913
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Fax | 707-423-7574
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Provider Business Mailing Address
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Address Line | 101 BODIN CIR 60TH MEDICAL GROUP
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City | TRAVIS AFB
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State | CA
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Zip | 94535-1809
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Country | US
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Telephone | 707-451-7913
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Fax | 707-423-7574
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Authorized Official
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Title or Position | AIR FORCE UBO ANALYST
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Name | JENNIFER LEWANDOWSKI
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Credential |
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Telephone | 703-817-4030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number |
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License Number State |
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