Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

412th Medgrp-Edwards

Organization Military/U.S. Coast Guard Outpatient Clinic/Center · NPI 1891765046

412th Medgrp-Edwards is a Military/U.S. Coast Guard Outpatient Clinic/Center in Edwards AFB, California. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3

Practice location Address checks out

30 Nightingale Rd Bldg 5525
Edwards AFB, CA 93524-0001
Phone: (661) 275-2634
Fax: (661) 277-6645
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Military/U.S. Coast Guard Outpatient Clinic/Center (primary) Taxonomy 261QM1100X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center Taxonomy 261QM1101X
Military/U.S. Coast Guard Pharmacy Taxonomy 332000000X

Record details

NPI number1891765046
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organization412th Medgrp-Edwards
Authorized official Jen Lewandowski — Air Force Ubo Analyst · (703) 817-4030
NPI enumeratedJanuary 23, 2006
Last updated in NPPESJune 16, 2025
Certification dateJune 16, 2025
Mailing address30 Nightingale Rd, Bldg 5525, Edwards Afb, CA 93524-0001