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

Nolan Andrew Ellis, DIVEIDC

Individual provider Independent Duty Corpsman · NPI 1174019046

Nolan Andrew Ellis, DIVEIDC is an Independent Duty Corpsman in San Diego, California. Practices as a sole proprietor. Registered with an NPI since 2018.

In the registry since
2018

Practice location Address checks out

3156 Salmon St
San Diego, CA 92124-3616
Phone: (859) 802-9800
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 number1174019046
Entity typeIndividual (Type 1)
GenderMale
Credentials DIVEIDC
Sole proprietorYes
NPI enumeratedJuly 3, 2018
Last updated in NPPESJuly 3, 2018

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