STEFAN GEORGE HERRSTROM
NPI 1184388258
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA
- Individual
- Male
- Military Health Care Provider
- Independent Duty Corpsman
About STEFAN HERRSTROM
This page provides the complete NPI Profile along with additional information for Stefan Herrstrom, a provider established in San Diego, California with a medical specialization in Military Health Care Provider, focusing in independent duty corpsman . The healthcare provider is registered in the NPI registry with number 1184388258 assigned on October 2021. The practitioner's primary taxonomy code is 1710I1002X with license number 1184388258 (CA). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1184388258 Verify this NPI
- Provider Name
- STEFAN GEORGE HERRSTROM
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 34101 FARENHOLT AVE SAN DIEGO, CA 92134
- Location Phone
- (619) 532-7968
- Mailing Address
- 349 E 9TH AVE COLLEGEVILLE, PA 19426
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-26-2021
- Last Update Date
- 09-08-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Military Health Care Provider Independent Duty Corpsman
- Taxonomy Code
- 1710I1002X
- Type
- Other Service Providers
- License No.
- 1184388258
- License State
- CA
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
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Other Providers at the Same Location
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SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
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SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
SAN DIEGOT, CA 92134
SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1184388258, enumerated as an "individual" on October 26, 2021.
The provider is located at 34101 FARENHOLT AVE SAN DIEGO, CA 92134 and the phone number is (619) 532-7968.
Military Health Care Provider with taxonomy code 1710I1002X and a focus in Independent Duty Corpsman.
