61St Medical Squadron in El Segundo - Military/u.s. Coast Guard Outpatient
61St Medical Squadron - NPI 1538145412
61St Medical Squadron is a Military/u.s. Coast Guard Outpatient in El Segundo, California. 61St Medical Squadron practices all healthcare services and medical treatments related to Military/u.s. Coast Guard Outpatient. The NPI Number for 61St Medical Squadron is 1538145412. The last update date is 2014-05-21.
61St Medical Squadron's current location address is 2420 Vela Way, El Segundo, California. You can contact this provider via phone number 3106536437 and fax number 3106530243. The mailing address for 61St Medical Squadron is 2420 Vela Way, El Segundo, California. To know further, please read the information below!
Provider Profile Detail
Provider Organization | 61St Medical Squadron |
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Address | 2420 Vela Way, El Segundo, California |
Phone Number | 3106536437 |
Fax Number | 3106530243 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | AF UBO ANA |
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Authorized Official Name | Mitchell M. Theresa |
Telephone Number | 7036817613 |
NPI Number Detail
NPI Number | 1538145412 |
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Provider Enumeration Date | 2005-12-21 |
Last Updated Date | 2014-05-21 |
Provider Mailing Address Detail
Address | 2420 Vela Way |
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City | El Segundo |
State | California (CA) |
Post Code | 902454659 |
Phone Number | 3106536437 |
Fax Number | 3106530243 |
Provider's Primary Taxonomy Detail
Speciality | Military/u.s. Coast Guard Outpatient |
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Taxonomy | 261Qm1100X |
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-dep |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
05-37918 | CA | NCPDP |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to 61St Medical Squadron by the Centers for Medicare & Medicaid Services?
The 61St Medical Squadron has been assigned the NPI (National Provider Identifier) 1538145412 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Can you provide the 61St Medical Squadron's physical address?
The 61St Medical Squadron is physically located at 2420 Vela Way, in the city of El Segundo, CA, with the postal code 902454659.
What is 61St Medical Squadron's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for 61St Medical Squadron is Military/u.s. Coast Guard Outpatient, and the corresponding taxonomy classification code for this specialized field is 261Qm1100X.
On what date did the Centers for Medicare & Medicaid Services issue the 1538145412 to 61St Medical Squadron?
The 61St Medical Squadron received its 1538145412 assignment from the Centers for Medicare & Medicaid Services on 2005-12-21.
As of what date were the details related to 61St Medical Squadron most recently updated or revised?
The information pertaining to 61St Medical Squadron, including its address, specialty, and other relevant details, was last updated or revised on 2014-05-21.
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