Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

JACOB FULTON SFIDC
NPI 1174438386
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Q: What is Jacob Fulton's NPI number?

The NPI number for Jacob Fulton is 1174438386. It was assigned to this individual provider in the NPPES registry on August 14, 2026.

Q: What is Jacob Fulton'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 Jacob Fulton was last updated on August 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days 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 August 14, 2026

35000 GUADALCANAL ST, SAN DIEGO, CA 92140(814) 516-1620 Get Directions Write a Review

NPPES record added: August 14, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Jacob Fulton Sfidc NPPES

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

JACOB FULTON SFIDC (NPI 1174438386) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since August 2026.

NPPES Registry Identity

NPI1174438386

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameJACOB FULTONCredential: SFIDC

Location Address35000 GUADALCANAL STSan Diego, CA 92140-5599

Mailing Address34101 Farenholt AveSan Diego, CA 92134-7000

Phone(814) 516-1620

Sole ProprietorNo

Enumeration DateAugust 14, 2026

NPPES CertifiedAugust 13, 2026

✔ NPI 1174438386 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.

35000 GUADALCANAL ST, San Diego, CA 92140

Open in Google Maps ↗

Other Providers at the Same Location NPPES 13

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

MR. RODEN ROSARIO QUIBUYEN PA-C

Military Health Care Provider

35000 GUADALCANAL ST
SAN DIEGO, CA 92140

San Diego County (619) 524-1963

REYNALDO L REYES JR. PHYSICIAN ASSISTANT

Military Health Care Provider (Independent Duty Corpsman)

35000 GUADALCANAL ST, BRANCH MEDICAL CLINIC MARINE CORPS RECRUIT DEPOT
SAN DIEGO, CA 92140

San Diego County (619) 532-4056

MR. GARY CHERRY JR. IDC

Military Health Care Provider (Independent Duty Corpsman)

35000 GUADALCANAL ST, BRANCH MEDICAL CLINIC MCRD
SAN DIEGO, CA 92140

San Diego County (619) 524-4045

SCOTT LA FALCE ATC

Specialist/Technologist (Athletic Trainer)

35000 GUADALCANAL ST
SAN DIEGO, CA 92140

San Diego County (619) 392-5425

MR. JAMES E COOK IDC

Military Health Care Provider (Independent Duty Corpsman)

35000 GUADALCANAL ST, BRANCH MEDICAL CLINIC MCRD
SAN DIEGO, CA 92140

San Diego County (619) 524-4102

LAURA J MAYENKNECHT NRP

Emergency Medical Technician, Paramedic

35000 GUADALCANAL ST
SAN DIEGO, CA 92140

San Diego County (619) 524-0833

XIN DU

Physician Assistant

35000 GUADALCANAL ST
SAN DIEGO, CA 92140

San Diego County (619) 524-4045

BRANCH MEDICAL CLINIC MCRD

Clinic/Center (Military/U.S. Coast Guard Outpatient)

35000 GUADALCANAL ST, BRANCH MEDICAL CLINIC MCRD
SAN DIEGO, CA 92140

San Diego County (619) 524-4102

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 Jacob Fulton's NPI number?

The NPI number for Jacob Fulton is 1174438386. It was assigned to this individual provider in the NPPES registry on August 14, 2026.

Where is Jacob Fulton located?

Jacob Fulton practices at 35000 Guadalcanal St, San Diego, CA 92140. The listed phone number is (814) 516-1620.

What is Jacob Fulton'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 Jacob Fulton was last updated on August 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days 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.