30TH MEDGRP-VANDENBERG
NPI 1477536126
Clinic/Center - Military/U.S. Coast Guard Outpatient in Vandenberg Afb, CA

Q: What is 30th Medgrp-Vandenberg's NPI number?

The NPI number for 30th Medgrp-Vandenberg is 1477536126. It was assigned to this organization in the NPPES registry on November 28, 2005.

Q: What is 30th Medgrp-Vandenberg's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Military/U.S. Coast Guard Outpatient, with taxonomy code 261QM1100X.

Active since November 28, 2005

338 S DAKOTA AVE, VANDENBERG AFB, CA 93437(805) 606-3012(805) 606-4474 Get Directions Write a Review

NPPES record last updated: June 12, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 12, 2025, Mar 12, 2025 (2 updates tracked since 2025).

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About 30th Medgrp-vandenberg NPPES

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

30TH MEDGRP-VANDENBERG (NPI 1477536126) is a healthcare organization registered as a military/u.s. coast guard outpatient in Vandenberg Afb, California and active in the NPI registry since November 2005. The organization lists Jen Lewandowski, Defense Health Agency (dha) Financi, as its authorized official.

NPPES Registry Identity

NPI1477536126

Entity TypeOrganization

Primary Taxonomy261QM1100X

Legal Business Name30TH MEDGRP-VANDENBERG

Location Address338 S DAKOTA AVEVandenberg Afb, CA 93437-6307

Mailing Address338 S Dakota AveVandenberg Afb, CA 93437-6307 · (805) 606-3012 · Fax (805) 606-4474

Phone(805) 606-3012

Fax(805) 606-4474

Organization SubpartYes

Authorized OfficialJen LewandowskiDefense Health Agency (dha) Financi · (703) 817-4030

Enumeration DateNovember 28, 2005

Last NPPES UpdateJune 12, 20252 updates tracked since enumeration

NPPES CertifiedJune 12, 2025

✔ NPI 1477536126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Military/U.S. Coast Guard OutpatientAmbulatory Health Care Facilities

Taxonomy Code261QM1100X

Definition

The Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.

Also ListedClinic/Center · Military and U.S. Coast Guard Ambulatory ProcedureTaxonomy 261QM1101X

Also ListedMilitary/U.S. Coast Guard PharmacyTaxonomy 332000000X

338 S DAKOTA AVE, Vandenberg Afb, CA 93437

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Other Identifiers 1

Other05-49759CA · Ncpdp

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.

JACOB RAY WINCHESTER PA STUDENT

Physician Assistant