Provider Demographics
NPI:1760497309
Name:SANGALANG, MARIA MELINDA BERNALES (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARIA MELINDA
Middle Name:BERNALES
Last Name:SANGALANG
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:BERNALES
Other - Last Name:SANGALANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:633 GOV CARLOS CAMACHO RD
Mailing Address - Street 2:SUITE 212
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:671-646-3375
Practice Address - Fax:671-649-2266
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUPOD-00006213E00000X
AZ00645213E00000X
HIPO-179213E00000X
AZ645213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery