Provider Demographics
NPI:1689009318
Name:MARIA MELINDA B SANGALANG
Entity Type:Organization
Organization Name:MARIA MELINDA B SANGALANG
Other - Org Name:ISLAND FOOT SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA MELINDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SANGALANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-646-3375
Mailing Address - Street 1:633 GOV CARLOS CAMACHO RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TAMUNING
Mailing Address - State:GUAM
Mailing Address - Zip Code:96913
Mailing Address - Country:UM
Mailing Address - Phone:671-777-2412
Mailing Address - Fax:671-649-2266
Practice Address - Street 1:633 GOV CARLOS G CAMACHO RD
Practice Address - Street 2:SUITE 212
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3195
Practice Address - Country:US
Practice Address - Phone:671-777-2412
Practice Address - Fax:671-649-2266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric