MEDICARE: JAMES HOCHHEIMER

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	1710I1002X	Independent Duty Corpsman	D7434155	CA

General Provider Information

NPI Number	:	1912391756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES HOCHHEIMER

Provider Business Mailing Address
First Line	:	4192 MOUNT ALIFAN PL
Second Line	:	UNIT F
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-2859
Country	:	US
Telephone Number	:	910-599-3379
Fax Number	:

Provider Business Practice Location Address
First Line	:	HM1 JAMES HOCHHEIMER USS JASON DUNHAM (DDG 109)
Second Line	:	UNIT 100336 BOX 1702
City	:	FPO
State	:	AE
Zip	:	09567
Country	:	US
Telephone Number	:	757-445-6115
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2015
Last Update Date	:	03/18/2015

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