MEDICARE: NAVAL HOSPITAL CAMP PENDLETON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1100X	Military/U.S. Coast Guard Outpatient Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1386604387	OTHER	CA	PARENT FACILITY NPI

General Provider Information

NPI Number	:	1366645442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAVAL HOSPITAL CAMP PENDLETON

Provider Business Mailing Address
First Line	:	PO BOX 555191
Second Line	:	FIN MGMT CODE 0814
City	:	CAMP PENDLETON
State	:	CA
Zip	:	92055-5191
Country	:	US
Telephone Number	:	760-725-1621
Fax Number	:	760-725-1661

Provider Business Practice Location Address
First Line	:	1 DISPENSARY ROAD
Second Line	:	BLDG 5
City	:	POINT MUGU
State	:	CA
Zip	:	93042-5017
Country	:	US
Telephone Number	:	760-725-1621
Fax Number	:	760-725-1661

Authorized Official
Title or Position	:	BUSINESS OFFICE SUPERVISOR
Name	:	JAMES H PETERMAN
Credential	:
Telephone Number	:	760-725-1661

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	04/07/2014

Similar Medicare Providers

1811951643 — MR. PAUL MCLAIN ZIEMER IDC
Practice Location Address:

NAVAL AMBULATORY CARE CLINIC POINT MUGU , 1 DISPENSARY RD, BLDG 5
POINT MUGU NAWC, CA
93042-0001

Practice Phone: 805-989-3916
Practice Fax:

1811189293 — LEO STEVEN RODRIGUEZ IDC
Practice Location Address:

BMA SAN NICOLAS IS , NAVAL OUTLYING LANDING FIELD
POINT MUGU NAWC, CA
93042-0001

Practice Phone: 805-989-8030
Practice Fax:

1700047578 — DR. ORLANDO GABRIEL CABRERA M.D.
Practice Location Address:

1 DISPENSARY RD
NAS POINT MUGU, CA
93042

Practice Phone: 805-989-7213
Practice Fax: 805-989-8448

1083157077 — DR. MARK PALCAN PSYD
Practice Location Address:

1 DISPENSARY RD
POINT MUGU NAWC, CA
93042-5051

Practice Phone: 805-989-8943
Practice Fax:

1184264780 — MICHAEL ALLEN PETRELLI DO
Practice Location Address:

1 DISPENSARY ROAD
POINT MUGU NAWC, CA
93042-0001

Practice Phone: 805-989-8815
Practice Fax:

1679451488 — USCG AIRSTA VENTURA
Practice Location Address:

190 3RD STREET
NAVAL AIR STATION POINT MUGU, CA
93042

Practice Phone: 805-874-3260
Practice Fax:

Directions to “NAVAL HOSPITAL CAMP PENDLETON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.