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General NPI Number Information
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NPI Number | 1912394727
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Entity Type | Organization
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Legal Business Name | NAVAL HOSPITAL TWENTYNINE PALMS
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | MCMWTC BLDG 3005 NAHBEMWTC
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City | BRIDGEPORT
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State | CA
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Zip | 93517-5010
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Country | US
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Telephone | 760-932-7255
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Fax | 760-932-7112
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Provider Business Mailing Address
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Address Line | NAVAL MEDICAL CENTER SAN DIEGO STE 20
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City | SAN DIEGO
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State | CA
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Zip | 92134-0001
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Country | US
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Telephone | 619-532-8400
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Fax |
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Authorized Official
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Title or Position | CHIEF DHA POSC
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Name | HECTOR MORALES
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Credential |
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Telephone | 210-536-6650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332000000X
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Taxonomy Name | Military/U.S. Coast Guard Pharmacy
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License Number |
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License Number State |
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