Provider Demographics
NPI:1952670382
Name:CANCER CENTER OF GUAM LLP SAMUEL J FRIEDMAN GEN PTR
Entity Type:Organization
Organization Name:CANCER CENTER OF GUAM LLP SAMUEL J FRIEDMAN GEN PTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEON GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-647-4656
Mailing Address - Street 1:633 GOV. CARLOS CAMACHO RD., B5
Mailing Address - Street 2:GUAM MEDICAL PLAZA
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-3194
Mailing Address - Country:US
Mailing Address - Phone:671-647-4656
Mailing Address - Fax:671-647-4660
Practice Address - Street 1:416 CHALAN SAN ANTONIO
Practice Address - Street 2:GOOD SAMARITAN BUILDING
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3601
Practice Address - Country:US
Practice Address - Phone:671-647-4656
Practice Address - Fax:671-647-4660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-13
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty