CHANTELLE PONDER IDC
NPI 1104467737
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Q: What is Chantelle Ponder's NPI number?

The NPI number for Chantelle Ponder is 1104467737. It was assigned to this individual provider in the NPPES registry on October 4, 2019.

Q: What is Chantelle Ponder's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Chantelle Ponder was last updated on October 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since October 04, 2019

34800 BOB WILSON DR, SAN DIEGO, CA 92134(619) 532-6400 Get Directions Write a Review

NPPES record last updated: October 4, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Chantelle Ponder Idc NPPES

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

CHANTELLE PONDER IDC (NPI 1104467737) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since October 2019. She maintains a secondary practice location in San Diego.

NPPES Registry Identity

NPI1104467737

Entity TypeIndividualFemale

Primary Taxonomy1710I1002X

Provider Legal NameCHANTELLE PONDERCredential: IDC

Location Address34800 BOB WILSON DRSan Diego, CA 92134-1098

Mailing Address34800 Bob Wilson DrSan Diego, CA 92134-1098

Phone(619) 532-6400

Sole ProprietorYes

Enumeration DateOctober 4, 2019

✔ NPI 1104467737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

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.

34800 BOB WILSON DR, San Diego, CA 92134

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Secondary Practice Location 1

Location 134800 Bob Wilson DrSan Diego, CA 92134-1098 · Phone (619) 532-6400

Other Providers at the Same Location NPPES 20

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

LORENA MARIE FUJII N.P.

Nurse Practitioner (Pediatrics)