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

Justin Benton Daugherty, IDC

Individual provider Independent Duty Corpsman · NPI 1992100911

Justin Benton Daugherty, IDC is an Independent Duty Corpsman in San Diego, California. Practices as a sole proprietor. Registered with an NPI since 2014.

In the registry since
2014

Practice location Address checks out

3124 Salmon St
San Diego, CA 92124-3605
Phone: (402) 699-7774
Show map & directions

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

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X

Record details

NPI number1992100911
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorYes
NPI enumeratedNovember 3, 2014
Last updated in NPPESNovember 3, 2014

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