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BRIAN JAMES JACKSON IDC
NPI 1194985861
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Active since June 16, 2008
35000 GUADALCANAL AVE, SAN DIEGO, CA 92140(619) 524-4045 Get Directions Write a Review

NPPES record last updated: June 16, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Brian James Jackson Idc NPPES

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

BRIAN JAMES JACKSON IDC (NPI 1194985861) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since June 2008.

NPPES Registry Identity

NPI1194985861
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameBRIAN JAMES JACKSONCredential: IDC
Location Address35000 GUADALCANAL AVESan Diego, CA 92140-5599
Mailing Address35000 Guadalcanal AveSan Diego, CA 92140-5599 · (619) 524-4045
Phone(619) 524-4045
Sole ProprietorNo
Enumeration DateJune 16, 2008
✔ NPI 1194985861 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 AVE, San Diego, CA 92140
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Other Providers at the Same Location NPPES 14

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

DR. ARTHUR WELLS WARD D.P.M.
Podiatrist (Sports Medicine)
35000 GUADALCANAL AVE, MCRD BRANCH MEDICAL CLINIC
SAN DIEGO, CA 92140
San Diego County (619) 524-8313
MR. EHREN LIETZ IDC
Military Health Care Provider (Independent Duty Corpsman)
35000 GUADALCANAL AVE
SAN DIEGO, CA 92140
San Diego County (619) 524-8397
YESENIA ASTORGA PA-C
Physician Assistant
35000 GUADALCANAL AVE, BMC MCRD
SAN DIEGO, CA 92140
San Diego County (619) 524-4045
ANNE DASILVA PA-C
Physician Assistant
35000 GUADALCANAL AVE, BRANCH HEALTH CLINIC MCRD
SAN DIEGO, CA 92140
San Diego County (619) 524-0807
VERONYKA T YOUNG IDC
Military Health Care Provider (Independent Duty Corpsman)
35000 GUADALCANAL AVE
SAN DIEGO, CA 92140
San Diego County (619) 524-4045
MR. DOUGLAS LEE FAISON PA-C
Physician Assistant (Medical)
35000 GUADALCANAL AVE, BRANCH MEDICAL CLINIC, MCRD BLD 596
SAN DIEGO, CA 92140
San Diego County (619) 524-0789
MR. BRIAN PATRICK LIVINGSTONE A.T.,C.
Specialist/Technologist (Athletic Trainer)
35000 GUADALCANAL AVE
SAN DIEGO, CA 92140
San Diego County (619) 524-8313
MR. DONALD REID ROSARIO IDC
Military Health Care Provider (Independent Duty Corpsman)
35000 GUADALCANAL AVE, BLDG 596
SAN DIEGO, CA 92140
San Diego County (619) 524-4045

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 Brian Jackson's NPI number?

The NPI number for Brian Jackson is 1194985861. It was assigned to this individual provider in the NPPES registry on June 16, 2008.

Where is Brian Jackson located?

Brian Jackson practices at 35000 Guadalcanal Ave, San Diego, CA 92140. The listed phone number is (619) 524-4045.

What is Brian Jackson'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 Brian Jackson was last updated on June 16, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.