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MR. JASON THOMAS WILLIAM TETZLAFF IDC
NPI 1043247091
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Active since June 26, 2006
3402 TARAWA RD, SBT-12, SAN DIEGO, CA 92155(619) 437-5539(619) 437-2955 Get Directions Write a Review

NPPES record last updated: April 22, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Jason Thomas William Tetzlaff Idc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JASON THOMAS WILLIAM TETZLAFF IDC (NPI 1043247091) is an individual independent duty corpsman provider in San Diego, California, licensed in Arizona (2099) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1043247091
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameMR. JASON THOMAS WILLIAM TETZLAFFCredential: IDC
Location Address3402 TARAWA RD, SBT-12San Diego, CA 92155-5176
Mailing Address4742 Gainard WaySan Diego, CA 92124-2913 · (619) 436-8538 · Fax (619) 437-2955
Phone(619) 437-5539
Fax(619) 437-2955
Sole ProprietorNo
Enumeration DateJune 26, 2006
Last NPPES UpdateApril 22, 2008
✔ NPI 1043247091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
License✔ Licensed in AZ · 2099
Definition
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Also ListedMilitary Health Care ProviderTaxonomy 171000000X · License 2099 (CA)
Also ListedSpecialistTaxonomy 174400000X
3402 TARAWA RD, San Diego, CA 92155
Open in Google Maps ↗

Other Identifiers 1

Other2099AZ · Us Navy

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIK DAVID MARKER
Military Health Care Provider (Independent Duty Corpsman)
3402 TARAWA RD, BLDG 19
SAN DIEGO, CA 92155
San Diego County (619) 437-2558
MR. MARVIN CAMARA SANCHEZ PA-C
Physician Assistant
3402 TARAWA RD
SAN DIEGO, CA 92155
San Diego County (619) 437-5539
SARA GIANAS DPT, HHP, FAFS, CSCS
Physical Therapist
3402 TARAWA RD
SAN DIEGO, CA 92155
San Diego County (619) 537-4112
JAMES ALFONSO ABEYTA IDC
Military Health Care Provider (Independent Duty Corpsman)
3402 TARAWA RD
SAN DIEGO, CA 92155
San Diego County (619) 437-5539

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jason Tetzlaff's NPI number?

The NPI number for Jason Tetzlaff is 1043247091. It was assigned to this individual provider in the NPPES registry on June 26, 2006.

Where is Jason Tetzlaff located?

Jason Tetzlaff practices at 3402 Tarawa Rd Sbt-12, San Diego, CA 92155. The listed phone number is (619) 437-5539.

What is Jason Tetzlaff's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Jason Tetzlaff was last updated on April 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.