Christopher Medina, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OL-029 Issued in GU

Practice address

Concourse 4 Micronesia Mall
Ideal Optical
Dededo, GU 96929

Phone

(671) 637-8141

NPI assigned

Mar 1, 2016

Last updated

Mar 1, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1669832846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24724",
            "city": "BARRIGADA",
            "state": "GU",
            "postal_code": "969214724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CONCOURSE 4 MICRONESIA MALL",
            "address_2": "IDEAL OPTICAL",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "96929",
            "telephone_number": "671-637-8141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-01",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GU",
            "license": "OL-029",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "GU",
            "license": "OL-029",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Ong Marimla
• Thora C. Mark, NP-C
• April Karen Valdez Marquez, DO, MPH
• Craig Matthews, RN
• Joseph Andrew McAllister, RPH
• Medpharm (Pro-Care Home-Health Supplies)
• Frankie Torres Mendiola, M.D.
• Joseph John Baza Mendiola
• Gregory John Miller, D.C.
• Daniel H Moges, M.D.

• 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 Mar 1, 2016; 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.