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

Individual provider Independent Duty Corpsman · NPI 1457633711

Mr. Bryan Judson Smith, DIVEIDC is an Independent Duty Corpsman in San Diego, California. Practices as a sole proprietor. Registered with an NPI since 2011.

In the registry since
2011
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Practice location Address checks out

34101 Farenholt Ave
San Diego, CA 92134-7000
Phone: (619) 532-6064
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X

Record details

NPI number1457633711
Entity typeIndividual (Type 1)
GenderMale
Credentials DIVEIDC
Sole proprietorYes
NPI enumeratedSeptember 13, 2011
Last updated in NPPESSeptember 13, 2011

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