PACIFIC MED & NEPHROLOGY (NPI# 1033391313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033391313 |
| Entity Type | Organization |
| Organization Name | PACIFIC MED & NEPHROLOGY |
| Other Organization Name | PACIFIC MEDICAL GROUP |
| Practice Address |
736 Route 4 Suite 103 Sinajana GU 96910 |
| Practice Telephone | 6716497232 |
| Practice Fax Number | 6716497233 |
| Mailing Telephone | 6716497232 |
| Mailing Fax Number | 6716497233 |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2019-02-15 |
| Authorized Official Name | MERSEDEH MADDAH (ADMINISTRATOR) |
| Authorized Official Telephone | 6716497232 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
261QM1300X | GU | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Pacific Medical Group | Doing Business As Name - Organization |
| Street Address |
736 ROUTE 4 SUITE 103 |
| City | SINAJANA |
| State | GU |
| Zip Code | 96910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447254891 | Laura D Alvez | Internal Medicine | 736 Route 4, Ste. 103, Sinajana, GUAM 96910 | 2005-06-13 |
| 1376931329 | Advanced Eyecare, LLC | Ophthalmology | 736 Route 4, Ste 103, Sinajana, GU 96910-3368 | 2014-12-29 |
| 1144638123 | Wil-mar Corporation | Pharmacy | 736 Route 4, Sinajana, GU 96910-3368 | 2014-07-23 |
| 1356618359 | Krystal Ann King | Physician Assistant | 736 Route 4, Ste. 103, Sinajana, GUAM 96910 | 2011-11-19 |
| 1881834109 | Robert Caing Nerves | Internal Medicine | 736 Route 4, Suite 103, Sinajana, GU 96910-3368 | 2009-02-26 |
| 1669647772 | Mary Grace Aguilar Santos | Internal Medicine | 736 Route 4, Suite 103, Sinajana, GU 96910-3368 | 2008-04-29 |
| 1588849541 | Rsa - Guam, LLC | Clinic/Center | 736 Route 4, Suite 101, Sinajana, GU 96910-3368 | 2008-01-08 |
| 1437251808 | Saied Safabakhsh | Internal Medicine | 736 Route 4, Suite 103, Sinajana, GU 96910-3368 | 2006-09-05 |
| 1124082227 | Tiffany J Troxel | Physician Assistant | 736 Route 4, Suite 103, Sinajana, GU 96910-3368 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518576230 | Bo Henry Marshall | Physician Assistant | 302 S Route 4 Ste 207, Hagatna, GU 96910 | 2020-07-28 |
| 1972133361 | Elizabeth Quilitis Camacho | Licensed Practical Nurse | 127 2nd St Ocean Vista Tiyan, Maite, GU 96910 | 2020-01-24 |
| 1588200497 | Carrie Margeson | Pharmacist | Bldg #50 Farenholt Ave, Tutuhan, GU 96910 | 2019-11-26 |
| 1265075188 | Amy C Romero | Counselor | 144 Afia Building Suite 201, Hagatna, GU 96910 | 2019-10-23 |
| 1710549589 | Carmela Santos | Registered Nurse | Bldg #50, Farenholt Ave, Tutuhan, GU 96910 | 2019-07-02 |
| 1912469404 | Daniel A. Duenas | Social Worker | 222 Chalan Santo Papa Reflection Center, Hagatna, GU 96910 | 2019-04-03 |
| 1598238891 | Steven Butler | Counselor | 144 Aspinal Ave., Afia Bld. Suite 202, Hagatna, GU 96910 | 2019-01-09 |
| 1790275675 | Evangeline Claassens | Nurse Practitioner | 736 South Route 4, Suite 103, Sinajana, GU 96910 | 2018-05-16 |
| 1356839575 | Evergreen Health Center LLC | Clinic/Center | 520 Route 8, Maite, GU 96910 | 2018-04-23 |
| 1902312382 | Sarah Burton | Pharmacist | Building 50 Farenholt Blvd, Agana Heights, GU 96910 | 2017-12-20 |
| Find all providers in zip 96910 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952550733 | Yoichi Inaba | Clinic/Center | 633 Governor Carlos Camacho R. Ste. 205, Tamuning, GU 96913 | 2008-09-16 |
| 1699957274 | Guam Sleep Center, LLC | Clinic/Center | 535 N. Marine Corps Drive, Unit 1a, Tamuning, GU 96913 | 2007-12-05 |
| 1972565240 | Takecare Insurance Company Inc. | Clinic/Center | 548 S Marine Corps. Dr, Tamuning, GU 96913 | 2006-04-03 |
| 1104060839 | Primary Multispecialty Clinic | Clinic/Center | 177 Chalan Pasaheru Ste C, Tamuning, GU 96913-4161 | 2009-04-24 |
| 1427069533 | Takecare Insurance Company, Inc. | Clinic/Center | 548 South Marine Corps Drive, Tamuning, GU 96913 | 2006-08-11 |
Please comment or provide details below to improve the information on PACIFIC MED & NEPHROLOGY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.