Charles Alexander Hall, IDC
Military Health Care Provider, Independent Duty Corpsman in Camp Pendleton, CA. Individual provider (NPI-1).
NPI number1962089649
StatusActive
Last updated in NPPESNov 11, 2021
Details
- NPI
- 1962089649
- Entity type
- Individual (NPI-1)
- Name
- Charles Alexander Hall
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2021
- Certification date
- Oct 25, 2021
- Last updated
- Nov 11, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1710I1002X | Military Health Care Provider, Independent Duty Corpsman | – | – | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
3d Aabn Battalion Aid StaionBldg 210735
Camp Pendleton, CA 92055
Phone 760-725-2192
Mailing address
34101 Farenholt Ave Bldg 14San Diego, CA 92134-7000
Phone 619-532-7968
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