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General NPI Number Information
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NPI Number | 1396616850
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Entity Type | Organization
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Legal Business Name | UNITED STATES SPACE FORCE
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 483 N AVIATION BLVD BLDG 286
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City | EL SEGUNDO
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State | CA
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Zip | 90245-2808
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Country | US
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Telephone | 310-653-1110
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Fax |
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Provider Business Mailing Address
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Address Line | 483 N AVIATION BLVD BLDG 286
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City | EL SEGUNDO
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State | CA
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Zip | 90245-2808
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NH-3
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Name | COLIN LIM
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Credential |
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Telephone | 310-653-1110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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