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JACOB GOTHRO
NPI 1184476301
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Active since April 02, 2024
34800 BOB WILSON DR, SAN DIEGO, CA 92134(602) 910-7372 Get Directions Write a Review

NPPES record last updated: April 2, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jacob Gothro NPPES

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

JACOB GOTHRO (NPI 1184476301) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since April 2024.

NPPES Registry Identity

NPI1184476301
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameJACOB GOTHRO
Location Address34800 BOB WILSON DRSan Diego, CA 92134-1098
Mailing Address34800 Bob Wilson DrSan Diego, CA 92134-1098 · (602) 910-7372
Phone(602) 910-7372
Sole ProprietorNo
Enumeration DateApril 2, 2024
NPPES CertifiedApril 2, 2024
✔ NPI 1184476301 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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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)
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 532-8910
LAKIESHA NICOLE MURPHY
Nurse's Aide
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 713-3385
SUSANNA BYRNE D.O.
Anesthesiology
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 532-6400
DR. PAUL CHARLES CAMPBELL D.O.
Urology (Pediatric Urology)
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 532-7200
PHILLIP EDWARD FRY JR. DO
Emergency Medicine
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 532-6400
BRADLY JAMES STILLEY IDC
Military Health Care Provider (Independent Duty Corpsman)
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (360) 941-9989
DR. ELIZABETH WHIPPLE PHD
Military Health Care Provider
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 532-6400
DR. ELAN HARDER BRESSLOUR-RASHAP MD
General Practice
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 532-6400

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 Gothro's NPI number?

The NPI number for Jacob Gothro is 1184476301. It was assigned to this individual provider in the NPPES registry on April 2, 2024.

Where is Jacob Gothro located?

Jacob Gothro practices at 34800 Bob Wilson Dr, San Diego, CA 92134. The listed phone number is (602) 910-7372.

What is Jacob Gothro'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 Gothro was last updated on April 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.