OrganizationActive
United States Coast Guard
NPI 1669689568 · Military/U.S. Coast Guard Outpatient Clinic/Center · Petaluma, CA
Provider details
- NPI number
- 1669689568
- Entity type
- Organization
- Primary specialty
- Military/U.S. Coast Guard Outpatient Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Todd Devore, Clinic Administrator(707) 971-9364
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
410 Pennsylvania Ave # a
Petaluma, CA 94952-9103
Phone: (707) 971-9364
Street-level locationGet directions
Mailing address
410 Pennsylvania Ave # a
Petaluma, CA 94952-9103
Registry dates
- Enumerated
- 2007-05-17
- Last updated
- 2008-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.