NPI 1336079003

Justin Carl Carpenter, IDC

Practitioner Independent Duty Corpsman Coronado, CA

Practice location

Address: 1405 Leyte Rd APT D, Coronado, CA 92118-3185
Phone: (513) 800-6866

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1336079003
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 May 2026
Record last updated: 22 May 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.