Tumon Medical Office
Organization Active NPI Family Medicine Physician · Tamuning, GU
NPI 1992987952 · NPPES record last updated Dec 3, 2007
Key facts
- NPI
- 1992987952
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- M001195 (GU)
- Legal business name
- TUMON MEDICAL OFFICE
- Practice address
- 125 Carlos LN
Carlos Heights
Tamuning, GU 96913-4339 - Phone
- (671) 649-5052
- NPI assigned
- Dec 3, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Patrick Santos, M.D.
- Title
- President
- Phone
- (671) 649-5052
Practitioners 2
-
Patrick C Santos, MD
-
Ricardo Mark Terlaje, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040311001259 | HI | Part B Supplier - Clinic/Group Practice | 4688563349 |
Receives reassigned benefits from 1 practitioner Practice locations: Tamuning, GU |
National Provider Directory
Locations
125 Carlos Ln
Uppr
Tamuning, GU 96913
Phone (671) 649-5052
125 Carlos Ln
Tamuning, GU 96913
Phone (671) 649-5052
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | M001195 | GU | Yes |
Addresses
Primary practice location
125 Carlos LN
Carlos Heights
Tamuning, GU 96913-4339
Mailing address
125 Carlos LN
Carlos Heights
Tamuning, GU 96913-4339
Phone (671) 649-5052
Other providers in Tamuning, GU
- Tri Enterprises Inc
- Tri Enterprises Inc.
- Trinity Healthcare, LLC.
- Dennis J Triolo
- Steven Andrew Tull
- Helene Duenas Tuncap
- Michael Um
- Leonora G Urbano
- Tom Serafica Veloria
- Stephanie Velsmid
All providers in Tamuning, GU · Family Medicine 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 Dec 3, 2007. 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.