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General NPI Number Information
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NPI Number | 1902153828
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Entity Type | Organization
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Legal Business Name | NAVAL MEDICAL CENTER SAN DIEGO
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 2005 KNIGHT LANE BLDG H NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SERVI
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City | JACKSONVILLE
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State | FL
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Zip | 32212-0140
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Country | US
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Telephone | 619-794-4459
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Fax |
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Provider Business Mailing Address
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Address Line | 7860 WESTSIDE DRIVE #308
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City | SAN DIEGO
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State | CA
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Zip | 92108
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Country | US
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Telephone | 630-300-4567
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Fax |
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Authorized Official
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Title or Position | GENERAL PRACTICE RESIDENT
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Name | DR. ERIN SHARI BAILEY
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Credential | D.D.S
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Telephone | 630-300-4567
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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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