Guam Geriatrics Clinic

Organization Active NPI Clinic/Center · Tamuning, GU

NPI 1487907234 · NPPES record last updated Apr 18, 2013

Key facts

NPI
1487907234
Entity type
Organization (NPI type 2)
Primary specialty
Clinic/Center 261Q00000X
License
M-1360 (GU)
Legal business name
GUAM GERIATRICS CLINIC
Practice address
633 Gov Carlos G Camacho Rd
Ste. 205
Tamuning, GU 96913-3194
Phone
(671) 649-7232
Fax
(671) 649-7233
NPI assigned
Oct 17, 2012
Organization subpart
No

Authorized official

Name
Mrs. Stephanie Ann Manibusan Untalan
Title
Administrative Assistant
Phone
(671) 649-7232

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X M-1360 GU Yes

Addresses

Primary practice location

633 Gov Carlos G Camacho Rd
Ste. 205
Tamuning, GU 96913-3194

Mailing address

633 Gov Carlos G Camacho Rd
Ste. 205
Tamuning, GU 96913-3194
Phone (671) 649-7232

Other identifiers

IdentifierTypeStateIssuer
1063517639OtherGUPROVIDER NPI

Other providers in Tamuning, GU

All providers in Tamuning, GU · Clinic/Center in Guam

Sources for this page

Verify at the official NPI Registry.