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

Mr. Jason Thomas William Tetzlaff, IDC

Individual provider Independent Duty Corpsman · NPI 1043247091

Mr. Jason Thomas William Tetzlaff, IDC is an Independent Duty Corpsman in San Diego, California. Licensed in Arizona and California. Registered with an NPI since 2006.

Licensed in
AZ, CA
In the registry since
2006
Specialties on file
3

Practice location Address checks out

3402 Tarawa Rd SBT-12
San Diego, CA 92155-5176
Phone: (619) 437-5539
Fax: (619) 437-2955
Show map & directions

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

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X · Licence 2099 (AZ)
Specialist Taxonomy 174400000X (CA)
Military Health Care Provider Taxonomy 171000000X · Licence 2099 (CA)

Record details

NPI number1043247091
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorNo
NPI enumeratedJune 26, 2006
Last updated in NPPESApril 22, 2008

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