Provider Demographics
NPI:1528397072
Name:DELPILAR, DONALD DADSON (IDC)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:DADSON
Last Name:DELPILAR
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CLB-1 HEADQUARTERS COMPANY
Mailing Address - Street 2:BOX 555737
Mailing Address - City:CAMP PENDELTON
Mailing Address - State:CA
Mailing Address - Zip Code:92055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CLB-1 HEADQUARTERS COMPANY
Practice Address - Street 2:BOX 555737
Practice Address - City:CAMP PENDELTON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-725-6821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman