BMC NAVAL BASE NPI 1003006628

Clinic/Center (Community Health) in San Diego, CA

About BMC NAVAL BASE

Bmc Naval Base is a provider in San Diego, CA. The NPI number assigned to this provider is 1003006628. The practitioner's primary taxonomy code is Clinic/Center (261QC1500X). The provider is registered as an organization and their NPI record was last updated 0 years ago.

NPI1003006628 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameBMC NAVAL BASE
Provider Location Address2450 CRAVEN STEET SAN DIEGO, CA 92136 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address2450 CRAVEN ST SAN DIEGO, CA 92136 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date07-30-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date12-19-2017 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

BMC NAVAL BASE
2450 CRAVEN STEET
SAN DIEGO, CA
ZIP 92136
Phone: (619) 556-6302
Fax: (619) 556-9419
Get Directions

Mailing Address

BMC NAVAL BASE
2450 CRAVEN ST
SAN DIEGO, CA
ZIP 92136
Phone: (619) 556-6302
Fax: (619) 556-9419

Primary Taxonomy

Taxonomy Code261QC1500X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationCommunity Health

Authorized Official

Authorized Official NameMR. WILLIAM MICHAEL CONDON Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitleNAVY MEDICINE UBO PROGRAM MANAGER
Authorized Official Phone(240) 401-3643

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
HSP63228FMEDICAID (05)CA

Map Location


BMC NAVAL BASE address is 2450 CRAVEN STEET SAN DIEGO, CA 92136