Provider Demographics
NPI:1285035352
Name:GUAM ANESTHESIA AND PAIN SERVICE
Entity Type:Organization
Organization Name:GUAM ANESTHESIA AND PAIN SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:REYNALD
Authorized Official - Middle Name:TE
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:671-988-7808
Mailing Address - Street 1:121 TAKANO LN
Mailing Address - Street 2:STE. 302
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-4148
Mailing Address - Country:US
Mailing Address - Phone:671-646-0230
Mailing Address - Fax:671-646-0497
Practice Address - Street 1:633 GOV. CARLOS CAMACHO ROAD
Practice Address - Street 2:STE. 202
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3195
Practice Address - Country:US
Practice Address - Phone:671-646-0443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty