Guam E.N.T., LLC
Organization Active NPI Otolaryngology Physician · Tamuning, GU
NPI 1124782701 · NPPES record last updated Oct 28, 2021
Key facts
- NPI
- 1124782701
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- Legal business name
- GUAM E.N.T., LLC
- Practice address
- 341 S Marine Corps Dr Ste 104
Tamuning, GU 96913-3970 - Phone
- (671) 989-1368
- Fax
- (671) 989-2360
- NPI assigned
- Oct 28, 2021
- Organization subpart
- No
Authorized official
- Name
- Trina L Techaira
- Title
- Clinic Manager
- Phone
- (671) 989-1368
Practitioners 4
-
Jerry Reyes Castro, M.D.
-
Lowell E. Ramos, PA-C
-
Ann Fenton, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GU
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220531000515 | GU | Part B Supplier - Clinic/Group Practice | 4284012451 |
Receives reassigned benefits from 2 practitioners Practice locations: Tamuning, GU |
National Provider Directory
Locations
341 S Marine Corps Dr
Ste 104
Tamuning, GU 96913
Phone (671) 482-6368
425 Chalan San Antonio
Tamuning, GU 96913
Phone (671) 747-8569
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician |
207Y00000X | Yes |
Addresses
Primary practice location
341 S Marine Corps Dr Ste 104
Tamuning, GU 96913-3970
Mailing address
341 S Marine Corps Dr Ste 104
Tamuning, GU 96913-3970
Phone (671) 989-1368
Other providers in Tamuning, GU
- Guahan Specialty and Wellness Center, LLC
- Guam Anesthesia and Pain Service
- Guam Anesthesia Services
- Guam Dermatology Institute LLC
- Guam Dialysis Center, Inc.
- Guam Geriatrics Clinic
- Guam Hematology Oncology Associates, Inc.
- Guam Medical Care, LLC
- Guam Medical Equipment and Supplies, LLC
- Guam Medical Equipment, LLC
All providers in Tamuning, GU · Otolaryngology Physician in Guam
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.