Individual provider · Type 1 NPI

Bradley Wayne Proctor, IDC

Independent Duty Corpsman · San Diego, CA

NPI number 1629635032 Active

Practice location

34101 Farenholt Ave
San Diego, CA 92134-7000

Call (619) 532-7968 Map

Mailing address

530 Glenwood St
Bossier City, LA 71111-2205

Specialties and licenses

TaxonomyCodeLicense
Independent Duty Corpsman Primary 1710I1002XNone listed

Independent Duty Corpsman: 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 othe…

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About NPI 1629635032

Bradley Wayne Proctor, IDC's National Provider Identifier is 1629635032, issued on May 21, 2019. The primary taxonomy on file is Independent Duty Corpsman (1710I1002X), and the practice location is in San Diego, CA. The record was last updated on Mar 11, 2025.