| NPI | 1124197017 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | WILLIAM JAMES PRIDGEN Ncoic Lpn Waedmaster 760-380-3144 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 286500000X Military Hospital (Licence: WA LP00045663) | 
| Enumeration Date | 2006-11-07 | 
| Last Update Date | 2020-08-22 |