Pacific Eye Center

Primary specialty

OptometristTaxonomy code 152W00000X

License

OL026 Issued in GU

Legal business name

PACIFIC EYE CENTER

Practice address

562 Harmon Loop Rd
Ste D2
Dededo, GU 96929

Phone

(671) 637-9889

Fax

(671) 632-5558

NPI assigned

Feb 27, 2007

Last updated

Jun 17, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Joel Mendoza Dizon, OD

Title

President

Phone

(671) 637-9889

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1366579468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 HARMON LOOP RD",
            "address_2": "STE D2",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "96929",
            "telephone_number": "671-637-9889",
            "fax_number": "671-632-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 HARMON LOOP RD",
            "address_2": "STE D2",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "96929",
            "telephone_number": "671-637-9889",
            "fax_number": "671-632-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC EYE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "DIZON",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "MENDOZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "671-637-9889",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GU",
            "license": "OL026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D3816501",
            "state": "GU"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marina NG
• Noel Silan, DPM, PC
• Verrad Kwasi Owusu Nyame, MD
• Rhoda Gaba Orallo, MSW, LCSW
• Dawn Dee Ostberg, FNP-BC
• Richard Paul J. Pajela, PT, DPT
• Palm Tree LLC (Dededo Dental Center)
• Palm Tree LLC
• Hope Marie Jacosalem Pangelinan, MSW
• Roen Geneel Manalo Pangilinan, PHARMD

• Optometrist in Dededo, GU
• Providers in Dededo, GU by specialty
• Optometrist in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.