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Zachary Haley

Military Health Care Provider, Independent Duty Corpsman in San Diego, CA. Individual provider (NPI-1).

NPI number1164097366
StatusActive
Last updated in NPPESApr 4, 2022

Details

NPI
1164097366
Entity type
Individual (NPI-1)
Name
Zachary Haley
Sex
Male
Sole proprietor
No
Enumeration date
May 21, 2021
Certification date
Apr 4, 2022
Last updated
Apr 4, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1710I1002X Military Health Care Provider, Independent Duty Corpsman––Yes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

3913 Ingraham St Apt U209
San Diego, CA 92109-5921

Phone 508-409-9408

Mailing address

3913 Ingraham St Apt U209
San Diego, CA 92109-5921

Phone 508-409-9408

Other practice locations

Surface Warfare Medical Institute
Fpo, AE 09582

Phone 508-409-9408

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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