OrganizationActive
Primary Multispecialty Clinic
NPI 1104060839 · Multi-Specialty Clinic/Center · Tamuning, GU
Provider details
- NPI number
- 1104060839
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Therese Chong, Patient Relations Coordinator(671) 688-1066
- License
- LEO 196 (GU)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
177 Chalan Pasaheru Ste C
Tamuning, GU 96913-4161
Phone: (671) 647-6201
Fax: (671) 647-0045
Mailing address
177 Chalan Pasaheru # a
Tamuning, GU 96913-4161
Registry dates
- Enumerated
- 2009-04-24
- Last updated
- 2009-04-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.