| Pacific Med & Nephrology | |
|
736 Route 4 Suite 103 Sinajana GU 96910 | |
| (671) 649-7232 | |
| (671) 649-7233 |
| Full Name | Pacific Med & Nephrology |
|---|---|
| Speciality | Clinic/Center |
| Location | 736 Route 4, Sinajana, Guam |
| Authorized Official Name and Position | Mersedeh Maddah (ADMINISTRATOR/OFFICE MANAGER) |
| Authorized Official Contact | 6716497232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Med & Nephrology 736 Route 4 Suite 103 Sinajana GU 96910 Ph: (671) 649-7232 | Pacific Med & Nephrology 736 Route 4 Suite 103 Sinajana GU 96910 Ph: (671) 649-7232 |
| NPI Number | 1033391313 |
|---|---|
| Provider Enumeration Date | 11/29/2007 |
| Last Update Date | 10/18/2022 |
| Medicare PECOS PAC ID | 1951296490 |
|---|---|
| Medicare Enrollment ID | O20040216000458 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033391313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 261QM1300X (Guam) | Primary |
| Provider Name | Saied Safabakhsh |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1437251808 PECOS PAC ID: 1456246909 Enrollment ID: I20060929000021 |
| Provider Name | Robert C Nerves |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1881834109 PECOS PAC ID: 4486707817 Enrollment ID: I20090803000677 |
| Provider Name | Laura D Alvez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447254891 PECOS PAC ID: 7810806015 Enrollment ID: I20100126000582 |
| Provider Name | Pichet Iampornpipopchai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679738330 PECOS PAC ID: 8123267556 Enrollment ID: I20130617000042 |
| Provider Name | Meagan J Bamba-ada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568874345 PECOS PAC ID: 3072835552 Enrollment ID: I20141212000269 |
| Provider Name | Vasin Jungtrakoolchai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528398682 PECOS PAC ID: 5193999134 Enrollment ID: I20151211000544 |
| Provider Name | Mana Dissadee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720390206 PECOS PAC ID: 2466727037 Enrollment ID: I20171006001908 |
| Provider Name | Carla Torres Haddock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710473996 PECOS PAC ID: 8224380936 Enrollment ID: I20181008003094 |
| Provider Name | Sherleen M Osman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871706358 PECOS PAC ID: 7618936600 Enrollment ID: I20181114002932 |
| Provider Name | Lilia Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912475872 PECOS PAC ID: 4587907969 Enrollment ID: I20190529000479 |
| Provider Name | Evangeline Claassens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790275675 PECOS PAC ID: 4981939451 Enrollment ID: I20190708000245 |
| Provider Name | Norman Berthiaume |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770691651 PECOS PAC ID: 2264521442 Enrollment ID: I20200116001276 |
| Provider Name | John Paul Gerard N Rosales |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1508098112 PECOS PAC ID: 8729234505 Enrollment ID: I20201029003015 |
| Provider Name | Azita Mesbah |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1184670630 PECOS PAC ID: 7810880671 Enrollment ID: I20210208002897 |
| Provider Name | Sarita F Stovall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598320210 PECOS PAC ID: 8123352754 Enrollment ID: I20221107001696 |
| Provider Name | Young Ho Kim |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1417100207 PECOS PAC ID: 6406919323 Enrollment ID: I20240215002998 |
| Provider Name | Duy Vu |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1447631866 PECOS PAC ID: 5991030033 Enrollment ID: I20240424003440 |
| Provider Name | Brian Wayne Greening |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922523463 PECOS PAC ID: 2264975044 Enrollment ID: I20240621000312 |
| Provider Name | Jonathan Warren Mcneely |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1528252079 PECOS PAC ID: 5991957623 Enrollment ID: I20240815000726 |