Jason Thomas Wil Tetzlaff in San Diego - Independent Duty Corpsman
Jason Thomas Wil Tetzlaff - NPI 1043247091
Jason Thomas Wil Tetzlaff is a Independent Duty Corpsman in San Diego, California. Jason Thomas Wil Tetzlaff practices all healthcare services and medical treatments related to Independent Duty Corpsman. The NPI Number for Jason Thomas Wil Tetzlaff is 1043247091. The last update date is 2008-04-22.
Jason Thomas Wil Tetzlaff's current location address is 3402 Tarawa Rd, San Diego, California. You can contact this provider via phone number 6194375539 and fax number 6194372955. The mailing address for Jason Thomas Wil Tetzlaff is 3402 Tarawa Rd, San Diego, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jason Thomas Wil Tetzlaff |
|---|---|
| Address | 3402 Tarawa Rd, San Diego, California |
| Phone Number | 6194375539 |
| Fax Number | 6194372955 |
| Sole Proprietor | N |
| Credentials | IDC |
NPI Number Detail
| NPI Number | 1043247091 |
|---|---|
| Provider Enumeration Date | 2006-06-26 |
| Last Updated Date | 2008-04-22 |
Provider Mailing Address Detail
| Address | 3402 Tarawa Rd |
|---|---|
| City | San Diego |
| State | California (CA) |
| Post Code | 921555176 |
| Phone Number | 6194375539 |
| Fax Number | 6194372955 |
Provider's Primary Taxonomy Detail
| Speciality | Independent Duty Corpsman |
|---|---|
| Taxonomy | 1710I1002X |
| Licence No | 2099 |
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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 v |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2099 | AZ | US NAVY |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Jason Thomas Wil Tetzlaff by the Centers for Medicare & Medicaid Services?
The Jason Thomas Wil Tetzlaff has been issued the NPI (National Provider Identifier) 1043247091 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Jason Thomas Wil Tetzlaff is physically located?
The Jason Thomas Wil Tetzlaff is physically situated at the following address: 3402 Tarawa Rd, San Diego, CA, 921555176.
What is Jason Thomas Wil Tetzlaff's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Jason Thomas Wil Tetzlaff is Independent Duty Corpsman, and the taxonomy classification code that categorizes this area of expertise is 1710I1002X.
On what date did the Jason Thomas Wil Tetzlaff receive its 1043247091 assignment from the Centers for Medicare & Medicaid Services?
The Jason Thomas Wil Tetzlaff was assigned its 1043247091 by the Centers for Medicare & Medicaid Services on 2006-06-26.
As of what date were the Jason Thomas Wil Tetzlaff's details last updated?
The information pertaining to the Jason Thomas Wil Tetzlaff, including its address, specialty, and other details, was most recently updated on 2008-04-22.