Uscg Isc San Pedro Clinic
Clinic/Center, MilitaryU.S. Coast Guard Outpatient in Washington, DC. Organization (NPI-2).
NPI number1003968942
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1003968942
- Entity type
- Organization (NPI-2)
- Legal business name
- Uscg Isc San Pedro Clinic
- Organization subpart
- No
- Enumeration date
- Jan 18, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1100X | Clinic/Center, MilitaryU.S. Coast Guard Outpatient | – | DC | Yes |
Practice location
2100 2nd St SwSuite 5314
Washington, DC 20593-0002
Phone 202-267-0801
Mailing address
2100 2nd St SwSuite 5314
Washington, DC 20593-0002
Authorized official
David Romero
Clinic Administrator
3107327500
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