IndividualActive
Moises Velasco, IDMT
NPI 1639300197 · Independent Duty Medical Technicians · Edwards Afb, CA
Provider details
- NPI number
- 1639300197
- Entity type
- Individual
- Primary specialty
- Independent Duty Medical TechniciansOther Service Providers
- Credential
- IDMT
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Other Service Providers
Practice location
412 Th Medical Group
30 Nightingale Rd.
Edwards Afb, CA 93524-0001
Phone: (661) 277-1130
Approximate (ZIP-level) locationGet directions
Mailing address
412 Th Medical Group
Edwards Afb, CA 93524-0001
Registry dates
- Enumerated
- 2009-07-31
- Last updated
- 2013-01-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.