30th Medgrp-Vandenberg
30th Medgrp-Vandenberg is a healthcare organization registered as Military/U.S. Coast Guard Outpatient Clinic/Center in Vandenberg Afb, CA, holding Type 2 (organization) NPI 1477536126 since 2005. The authorized official on file is Jen Lewandowski, Defense Health Agency (Dha) Financi.
✓ Active NPI ✓ Valid NPI checksum Organization subpart
| NPI | 1477536126 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | 30th Medgrp-Vandenberg |
| Parent organization | 30th Medgrp-Vandenberg |
| Practice address | 338 S DAKOTA AVE, Vandenberg Afb, CA, 93437 |
| Phone | 8056063012 |
| Fax | 8056064474 |
| Enumeration date | 2005-11-28 |
| Last updated in NPPES | 2025-06-12 |
Authorized official
| Name | Jen Lewandowski |
|---|---|
| Title | Defense Health Agency (Dha) Financi |
| Phone | 7038174030 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QM1101X | Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center | Secondary | — | — |
| 332000000X | Military/U.S. Coast Guard Pharmacy | Secondary | — | — |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05-49759 | Other | CA | NCPDP |
Copy-ready billing details
Provider: 30th Medgrp-Vandenberg NPI: 1477536126 Taxonomy: 261QM1100X (Military/U.S. Coast Guard Outpatient Clinic/Center) Address: 338 S DAKOTA AVE, Vandenberg Afb, CA, 93437
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1760477384 | Lorie Chan | Individual | Dentist | Vandenberg Afb, CA |
| 1821072794 | David Kieser | Individual | Dentist | Vandenberg Afb, CA |
| 1417929613 | Arthur Kisby | Individual | Pharmacist | Vandenberg Afb, CA |
| 1356377527 | Anderson Rowan | Individual | Clinical Psychologist | Vandenberg Afb, CA |
| 1245262864 | Alan Napoles | Individual | General Practice Dentistry | Vandenberg Afb, CA |
| 1215944814 | William Jennings | Individual | General Practice Dentistry | Vandenberg Afb, CA |
| 1124038534 | Health and Wellness Center | Organization | Military Hospital | Vandenberg Afb, CA |
| 1083707780 | Jared Detter | Individual | Psychologist | Vandenberg Afb, CA |
Verify this record
Cross-check NPI 1477536126 against the authoritative CMS record: view 30th Medgrp-Vandenberg on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for 30th Medgrp-Vandenberg?
Who is the authorized official for 30th Medgrp-Vandenberg?
Source: CMS NPPES (public data). Snapshot 2026-07-09. Provider record last updated 2025-06-12.