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548 S Marine Corps. Dr Tamuning GU 96913 | |
| (671) 646-6956 | |
| (671) 647-3556 |
| Full Name | |
|---|---|
| Speciality | Health Maintenance Organization |
| Location | 548 S Marine Corps. Dr, Tamuning, Guam |
| Authorized Official Name and Position | Lucio Alberto Villamayor Almira (CSG ADMINISTRATOR/CONTROLLER) |
| Authorized Official Contact | 6716466956 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
P.o. Box 6578 Tamuning GU 96931-6578 Ph: (671) 646-6956 | 548 S Marine Corps. Dr Tamuning GU 96913 Ph: (671) 646-6956 |
| NPI Number | 1972565240 |
|---|---|
| Provider Enumeration Date | 04/03/2006 |
| Last Update Date | 08/29/2023 |
| Medicare PECOS PAC ID | 8325951239 |
|---|---|
| Medicare Enrollment ID | O20140918000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972565240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (Guam) | Secondary |
| 302R00000X | Health Maintenance Organization | 1141450 (Guam) | Primary |
| Provider Name | Marlene R San Nicolas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154381515 PECOS PAC ID: 4082603923 Enrollment ID: I20040507000097 |
| Provider Name | Wendy D Frickel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760475966 PECOS PAC ID: 7012987688 Enrollment ID: I20070726000172 |
| Provider Name | Vincent V Lizama |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417918764 PECOS PAC ID: 5698766780 Enrollment ID: I20120413000684 |
| Provider Name | Aftab A Chaudhry |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1912977281 PECOS PAC ID: 6305736745 Enrollment ID: I20120612000665 |
| Provider Name | Andrew D Graves |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760696702 PECOS PAC ID: 4981857398 Enrollment ID: I20130116000148 |
| Provider Name | Trenton Scheibe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063630606 PECOS PAC ID: 0143305581 Enrollment ID: I20130320000585 |
| Provider Name | Juan C Quiros |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689679607 PECOS PAC ID: 4587734082 Enrollment ID: I20131108000959 |
| Provider Name | Vincent S Duenas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134430192 PECOS PAC ID: 6901032861 Enrollment ID: I20131122001878 |
| Provider Name | Marylou A Dulay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467659326 PECOS PAC ID: 6204925621 Enrollment ID: I20141007001471 |
| Provider Name | Mo-ping M Tham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851462139 PECOS PAC ID: 9739281288 Enrollment ID: I20141114002014 |
| Provider Name | Michael Fenton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033183264 PECOS PAC ID: 2961640602 Enrollment ID: I20141212000276 |
| Provider Name | Sydney Welt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740256809 PECOS PAC ID: 0042296543 Enrollment ID: I20150522001724 |
| Provider Name | Pei-chang Liu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881929156 PECOS PAC ID: 6507030624 Enrollment ID: I20151021001513 |
| Provider Name | Vasin Jungtrakoolchai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528398682 PECOS PAC ID: 5193999134 Enrollment ID: I20151211000544 |
| Provider Name | Teofila Maria P Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548500291 PECOS PAC ID: 1355648379 Enrollment ID: I20160401001958 |
| Provider Name | Nancy A Lentz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548559149 PECOS PAC ID: 8325360787 Enrollment ID: I20160404001474 |
| Provider Name | Samir S Ambrale |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1780990382 PECOS PAC ID: 3072815919 Enrollment ID: I20160902001992 |
| Provider Name | Michael C Agustin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1215248356 PECOS PAC ID: 2163700881 Enrollment ID: I20161101001526 |
| Provider Name | Michele Therese L Yamamoto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083902464 PECOS PAC ID: 3577791565 Enrollment ID: I20161101002413 |
| Provider Name | Edwin Supit |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518904812 PECOS PAC ID: 2466449863 Enrollment ID: I20170113001952 |
| Provider Name | Stephen Pomeranz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285639690 PECOS PAC ID: 7618880824 Enrollment ID: I20170113002325 |
| Provider Name | Ashley G P Artero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427598366 PECOS PAC ID: 1153607080 Enrollment ID: I20170407001501 |
| Provider Name | Stephen B Eigles |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619970787 PECOS PAC ID: 3072410042 Enrollment ID: I20170420001024 |
| Provider Name | Sumathi Wable |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447345665 PECOS PAC ID: 7719962091 Enrollment ID: I20170606001544 |
| Provider Name | Lena M Leishman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487195053 PECOS PAC ID: 2769759125 Enrollment ID: I20170606002594 |
| Provider Name | Norman Pennington |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295728251 PECOS PAC ID: 8527960251 Enrollment ID: I20180607001115 |
| Provider Name | John J Kim |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093702615 PECOS PAC ID: 3274851530 Enrollment ID: I20200316002590 |
| Provider Name | Crystal Ingram |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588196836 PECOS PAC ID: 1658641097 Enrollment ID: I20200918001669 |
| Provider Name | James P Anglim |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003903717 PECOS PAC ID: 7012067432 Enrollment ID: I20210308002583 |
| Provider Name | Julie S Namm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740515030 PECOS PAC ID: 2163617283 Enrollment ID: I20220208002766 |
| Provider Name | Dawn D Ostberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376143560 PECOS PAC ID: 7012307168 Enrollment ID: I20220506000845 |
| Provider Name | Mary K Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255313045 PECOS PAC ID: 7012065006 Enrollment ID: I20220802002852 |
| Provider Name | Katrina M Ostermann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588044176 PECOS PAC ID: 3678813607 Enrollment ID: I20220921002046 |
| Provider Name | William Michalides |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265054688 PECOS PAC ID: 8426471434 Enrollment ID: I20230531000599 |
| Provider Name | Matthew M Boles |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730573056 PECOS PAC ID: 8224401997 Enrollment ID: I20230907003822 |
| Provider Name | Gabriel C Miranda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013544261 PECOS PAC ID: 6709263049 Enrollment ID: I20231130002040 |
| Provider Name | Esther L Guard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497018246 PECOS PAC ID: 5092947630 Enrollment ID: I20240930002208 |
Pacific Cardiology Consultants Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 633 Gov Carlos G Camacho Rd, Suite 210, Guam Medical Plaza, Tamuning, GU 96913 Phone: 671-649-1001 Fax: 671-649-1002 | |
Spectrum Consulting Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 280 Pale San Vitores Rd, Tamuning, GU 96913 Phone: 671-689-4219 | |
Todu Guam Foundation Ltd Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 125 Tun Jesus Crisostomo St Ste 104, Tamuning, GU 96913 Phone: 671-649-8638 Fax: 671-648-5463 | |
Primary Multispecialty Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 177 Chalan Pasaheru Ste C, Tamuning, GU 96913 Phone: 671-647-6201 Fax: 671-647-0045 | |