KEOKY DELAPENA
Military Health Care Provider (Independent Duty Corpsman)

Address: 14101 Farenholt Avenue Bldg 14, San Diego, CA 92134-5291

KEOKY DELAPENA (NPI# 1124619861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124619861
Entity Type Individual
Full Name KEOKY DELAPENA
Gender Male
Credential IDC STUDENT
Practice Address 14101 Farenholt Avenue Bldg 14
San Diego
CA 92134-5291
Practice Telephone 6195327968
Mailing Address 14101 Farenholt Avenue Bldg 14
San Diego
CA 92134-5291
Mailing Telephone 6195327968
Certification Date 2021-01-26
Enumeration Date 2021-01-26
Last Update Date 2021-01-26
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Taxonomy Group
Y 1710I1002X Military Health Care Provider
Specialization: Independent Duty Corpsman
Other Service Providers

Office Location

Street Address 14101 FARENHOLT AVENUE BLDG 14
City SAN DIEGO
State CA
Zip Code 92134-5291

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932651148 Casey Steele Military Health Care Provider · Independent Duty Corpsman Surface Warefare Medical Institute, 34101 Farenholt Avenue, Building 14, San Diego, CA 92134-5291 2016-11-04
1720345804 Kyle Patrick Mcnamara Military Health Care Provider 34101 Farenholt Avenue, Building 14, San Diego, CA 92134-5291 2012-04-13
1609046432 Carolyn Lababit Rodriguez Radiologic Technologist 34101 Fraenholt Avenue, Naval School of Health Sciences, San Diego, CA 92134-5291 2008-03-07
1023501301 Jared Michael O'Brien Military Health Care Provider · Independent Duty Corpsman 34101 Farenholt Ave Bldg 14, San Diego, CA 92134-5291 2018-06-11
1407359763 Frederick Roy Novella Military Health Care Provider · Independent Duty Corpsman 34101 Farenholt Ave Bldg 14, San Diego, CA 92134-5291 2018-03-13
1316440670 Michael Anthony Anderson Military Health Care Provider · Independent Duty Corpsman 34101 Farenholt Ave Bldg 14, San Diego, CA 92134-5291 2018-03-13
1902304694 Jason Douglas Beadore-Minoff Military Health Care Provider · Independent Duty Corpsman 34101 Farenholt Ave Bldg 14, San Diego, CA 92134-5291 2018-01-27
1356869473 Thomas William Gordon Military Health Care Provider · Independent Duty Corpsman 34101 Farenholt Avenue, Building 14, San Diego, CA 92134-5291 2017-09-08
1154865764 Priscilla Stephanie Alejo Military Health Care Provider · Independent Duty Corpsman 34101 Farenholt Ave Bldg 14, San Diego, CA 92134-5291 2016-12-15
1497298913 Alan Aaron Military Health Care Provider · Independent Duty Corpsman 34101 Farenholt Ave, Building 14, San Diego, CA 92134-5291 2016-12-01
Find all providers in zip 92134-5291

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1477178457 Joseph Hunter Sampson Military Health Care Provider · Independent Duty Corpsman 34101 Farenholt Ave #14, San Diego, CA 92134 2020-06-15
1508495201 Benjamin Michael Taylor Military Health Care Provider Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 2020-04-04
1255870333 Dosh Page Physician Assistant Swmi Farenholt Avenue, Building 14, San Diego, CA 92134 2017-02-22
1417328063 Noem Clay Gallego Military Health Care Provider · Independent Duty Corpsman 34101 Building 14, Farenholt Avenue, San Diego, CA 92134 2015-10-08
1972999183 Justin Paul Lachney Military Health Care Provider · Independent Duty Corpsman 34101 Farenholt Avenue, San Diego, CA 92134 2015-04-14
1174963532 Ryan Anders Crane Otolaryngology Department of Otolaryngology - Nmc San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134 2013-07-01
1447591268 Amy B. Cornell Student in an Organized Health Care Education/Training Program 34800 Bob Wilson Drive, San Diego, Ca, Apo, AA 92134 2013-03-04
1841562956 Christopher Patrick Androski Jr. Emergency Medical Technician, Basic Naval Medical Center San Diego 38400 Bob Wilson Dr, San Diego, CA 92134 2012-02-04
1164717740 Jason James Weiner Internal Medicine · Rheumatology Dept of Internal Medicine, Division of Rheumatology, 34800 Bob Wilson Drive, San Diego, CA 92134 2011-06-13
1225320237 Kimberly Ann Thompson Student in an Organized Health Care Education/Training Program Navy Medical Center San Diego Gme Department, 34800 Bob Wilson Dr., San Diego, CA 92134 2011-05-09
Find all providers in zip 92134

Taxonomy Information

Taxonomy Code 1710I1002X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Corpsman

Taxonomy Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1780274456 Tinsae Tekleab 2464 Fenton Pkwy Apt 308, San Diego, CA 92108-6704 2021-01-26
1801492145 Felicia Leanna Roberts 2267 Reed Ave, San Diego, CA 92109-5628 2020-12-10
1720684319 Brandon Young 3401 Farenholt Ave Building 14, San Diego, CA 92134-0001 2020-12-08
1770180648 Darius Lee Sean Woods 6033 Sandy Shore Ct, San Diego, CA 92139-1014 2020-10-05
1174130744 Daniel Carrera 2645 W Canyon Ave Apt 450, San Diego, CA 92123-4700 2020-09-28
1316551740 Kyle Bode Francis 3149 Murray Ridge Rd, San Diego, CA 92123-2917 2020-09-02
1255945069 Jeremy Lee 509 Dennery Rd Apt 145, San Diego, CA 92154-8542 2020-08-31
1013520667 Rashaad Brown 4454 Cherokee Ave Apt 2, San Diego, CA 92116-3611 2020-08-24
1932711934 Alvaro Daniel Macias 8685 Rio San Diego Dr Apt 4344, San Diego, CA 92108-6560 2020-08-20
1255943635 Stephon Peyton Frost 2654 Mendonca Dr, San Diego, CA 92110-4263 2020-08-18
Find all providers in SAN DIEGO

Competitor

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City SAN DIEGO
Zip Code 92134

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.