| Commonwealth Medical Center LLC | |
|
Micro Beach Road, Garapan Saipan MP 96950-0003 | |
| (670) 989-2587 | |
| Not Available |
| Full Name | Commonwealth Medical Center LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | Micro Beach Road, Garapan, Saipan, Northern Mariana Islands |
| Authorized Official Name and Position | Ni Nie Deleon Guerrero (OWNER) |
| Authorized Official Contact | 6704880265 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Medical Center LLC Pmb 145 Box 10003 Saipan MP 96950-8903 Ph: (670) 488-0265 | Commonwealth Medical Center LLC Micro Beach Road, Garapan Saipan MP 96950-0003 Ph: (670) 989-2587 |
| NPI Number | 1316646185 |
|---|---|
| Provider Enumeration Date | 03/01/2023 |
| Last Update Date | 09/15/2026 |
| Certification Date | 09/15/2026 |
| Medicare PECOS PAC ID | 7416312210 |
|---|---|
| Medicare Enrollment ID | O20230501001876 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316646185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (NU) | Primary |
| 207Q00000X | Family Medicine | (NU) | Secondary |
| Provider Name | Dirk L Tanner |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912182635 PECOS PAC ID: 4284719816 Enrollment ID: I20220628002756 |
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