Mr. Jason Thomas William Tetzlaff, IDC - San Diego, CA

Mr. Jason Thomas William Tetzlaff, IDC

Military Health Care Provider in San Diego, California

NPI 1043247091

Jason Thomas William Tetzlaff is a Military Health Care Provider based in San Diego, CA. Jason Thomas William Tetzlaff practices in San Diego, CA and has the professional credentials of IDC. The NPI Number for Jason Thomas William Tetzlaff is 1043247091 and holds a License No. 2099 (California).

The current practice location address for Jason Thomas William Tetzlaff is 3402 Tarawa Rd, San Diego, CA and can be reached out via phone at 619-437-5539 and via fax at 619-437-2955. You can also correspond with Jason Thomas William Tetzlaff through the mailing address at 4742 GAINARD WAY, SAN DIEGO, CA - 92124-2913 (mailing address contact number: 619-436-8538).

Location: 3402 Tarawa Rd, San Diego, CA, 92124-2913

NPI Number

1043247091

Provider Name

Jason Thomas William Tetzlaff

Credential

IDC

Provider Entity Type

Individual

Gender

Male

Address

3402 Tarawa Rd, San Diego, CA, 92124-2913

Phone Number

619-437-5539

Fax Number

619-437-2955

Provider Enumeration Date

06/26/2006

Last Update Date

03/08/2024

Identifier	Type	State	Issuer
2099	01	AZ	US NAVY

Address

3402 Tarawa Rd

City

San Diego

State

California

Zip

92155-5176

Phone Number

619-437-5539

Fax Number

619-437-2955

Address

4742 Gainard Way

City

San Diego

State

California

Zip

92124-2913

Phone Number

619-436-8538

Fax Number

619-437-2955

Type

Other Service Providers

Classification

Military Health Care Provider

Speciality

Taxonomy

171000000X

License No.

2099 (California)

Definition

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

Type

Other Service Providers

Classification

Military Health Care Provider

Speciality

Independent Duty Corpsman

Taxonomy

1710I1002X

License No.

(California)

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.

Type

Other Service Providers

Classification

Specialist

Speciality

Taxonomy

174400000X

License No.

2099 (Arizona)

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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