Daryl Tolentino Camacho

Individual provider Active NPI Licensed Practical Nurse · Tamuning, GU

NPI 1184338451 · NPPES record last updated Jan 10, 2023

Key facts

NPI
1184338451
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LX0513 (GU)
Practice address
643 Chalan San Antonio
Tamuning, GU 96913-3644
Phone
(671) 735-8000
NPI assigned
Jan 10, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LX0513GUMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LX0513 GU Yes

Addresses

Primary practice location

643 Chalan San Antonio
Tamuning, GU 96913-3644

Mailing address

143 Dulalas Loop # 506
Yigo, GU 96929-2411
Phone (671) 929-6416

Other providers in Tamuning, GU

All providers in Tamuning, GU · Licensed Practical Nurse in Guam

Sources for this page

Verify at the official NPI Registry.