Organization · Type 2 NPI

412th Medgrp-Edwards

Military/U.S. Coast Guard Outpatient Clinic/Center · Edwards Afb, CA

NPI number 1891765046 Active

Practice location

30 Nightingale Rd, Bldg 5525
Edwards Afb, CA 93524-0001

Fax (661) 277-6645

Specialties and licenses

Taxonomy	Code	License
Military/U.S. Coast Guard Outpatient Clinic/Center Primary	261QM1100X	None listed
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center	261QM1101X	None listed
Military/U.S. Coast Guard Pharmacy	332000000X	None listed

Military/U.S. Coast Guard Outpatient Clinic/Center: The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as exam…

13 other providers at this address

About NPI 1891765046

412th Medgrp-Edwards's National Provider Identifier is 1891765046, issued on Jan 23, 2006. The primary taxonomy on file is Military/U.S. Coast Guard Outpatient Clinic/Center (261QM1100X), and the practice location is in Edwards Afb, CA. The record was last updated on Jun 16, 2025.