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  7. NPI Record 1750676938

MR. JOSEPH MICHAEL CHILDERS
Complete NPI Record 1750676938
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

NPI Status: Active since June 15, 2011

Contact Information

SEAL TEAM THREE MEDICAL
2642 TRIDENT WAY
SAN DIEGO, CA
ZIP 92155
Phone: (619) 524-9356
Fax: (619) 524-9207

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider First Line Business Mailing Address
  8. Provider Second Line Business Mailing Address
  9. Provider Business Mailing Address City Name
  10. Provider Business Mailing Address State Name
  11. Provider Business Mailing Address Postal Code
  12. Provider Business Mailing Address Country Code If outside U S
  13. Provider Business Mailing Address Telephone Number
  14. Provider Business Mailing Address Fax Number
  15. Provider First Line Business Practice Location Address
  16. Provider Second Line Business Practice Location Address
  17. Provider Business Practice Location Address City Name
  18. Provider Business Practice Location Address State Name
  19. Provider Business Practice Location Address Postal Code
  20. Provider Business Practice Location Address Country Code If outside U S
  21. Provider Business Practice Location Address Telephone Number
  22. Provider Business Practice Location Address Fax Number
  23. Provider Enumeration Date
  24. Last Update Date
  25. Provider Gender Code
  26. Healthcare Provider Taxonomy Code 1
  27. Healthcare Provider Primary Taxonomy Switch 1
  28. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1750676938. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1750676938
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: JOSEPH
The first name of the provider, if the provider is an individual.
Provider Middle Name: MICHAEL
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: MR.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider First Line Business Mailing Address: PO BOX 357054
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing Address: SAN CLEMENTE ISLAND BRANCH MEDICAL CLINIC
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City Name: FPO
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: AP
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 921357054
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 6195249356
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 6195249207
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: SEAL TEAM THREE MEDICAL
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: 2642 TRIDENT WAY
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: SAN DIEGO
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: CA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 921555492
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 6195249356
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 6195249207
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/15/2011
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 6/15/2011
The date that a record was last updated or changed.
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 1710I1002X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No