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MR. TIMOTHY D HUDERT IDC
NPI 1154109460
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Active since September 18, 2023
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134(862) 226-0653 Get Directions Write a Review

NPPES record last updated: September 18, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mr. Timothy D Hudert Idc NPPES

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

MR. TIMOTHY D HUDERT IDC (NPI 1154109460) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since September 2023.

NPPES Registry Identity

NPI1154109460
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameMR. TIMOTHY D HUDERTCredential: IDC
Location Address34101 FARENHOLT AVE BLDG 14San Diego, CA 92134-7000
Mailing Address34101 Farenholt Ave Bldg 14San Diego, CA 92134-7000 · (862) 226-0653
Phone(862) 226-0653
Sole ProprietorNo
Enumeration DateSeptember 18, 2023
NPPES CertifiedSeptember 18, 2023
✔ NPI 1154109460 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.

34101 FARENHOLT AVE BLDG 14, San Diego, CA 92134
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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.

MR. JEFFREY ALLEN TICE IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-5103
MR. MARK CONWAY VALENCIA IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (310) 974-2367
MS. CONNIE JEAN LAWSON IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-5135
MR. ANDRE RAMON KIRKENDOLL IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14, SURFACE WARFARE MEDICAL INSTITUTE SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
San Diego County (619) 532-5099
JASON SEEFORTH IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-5103
DR. STEVEN L BANKS D.O.
Emergency Medicine
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-7826
NATHANAEL LEE WARREN
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-6233
MR. JOSHUA ROMAN SMITH IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-6233

Frequently Asked Questions

What is Timothy Hudert's NPI number?

The NPI number assigned to this healthcare provider is 1154109460, enumerated as an "individual" on September 18, 2023.

Where is the provider located?

The provider is located at 34101 FARENHOLT AVE BLDG 14 SAN DIEGO, CA 92134 and the phone number is (862) 226-0653.

What is the provider's specialty?

Military Health Care Provider with taxonomy code 1710I1002X and a focus in Independent Duty Corpsman.