Provider Demographics
NPI:1144587692
Name:MANGLONA, JOAQUIN MUNA (PROPRIETOR/OWNER)
Entity Type:Individual
Prefix:MR
First Name:JOAQUIN
Middle Name:MUNA
Last Name:MANGLONA
Suffix:
Gender:M
Credentials:PROPRIETOR/OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 500732
Mailing Address - Street 2:CHALAN KANOA
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-8903
Mailing Address - Country:US
Mailing Address - Phone:670-235-7642
Mailing Address - Fax:670-235-7642
Practice Address - Street 1:SUSUPE BEACH ROAD, JM MANGLONA BUILDING UNIT 2
Practice Address - Street 2:JOAQUIN M. MANGLONA DBA UNIVERSAL HEALTH CARE
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-8903
Practice Address - Country:US
Practice Address - Phone:670-235-7642
Practice Address - Fax:670-235-7642
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MP380-0014-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health