Provider Demographics
NPI:1063150530
Name:TODU GUAM FOUNDATION LTD
Entity type:Organization
Organization Name:TODU GUAM FOUNDATION LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVO-RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-649-8638
Mailing Address - Street 1:125 TUN JESUS CRISOSTOMO ST STE 104
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-3551
Mailing Address - Country:US
Mailing Address - Phone:671-649-8638
Mailing Address - Fax:671-648-5463
Practice Address - Street 1:125 TUN JESUS CRISOSTOMO ST STE 104
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3551
Practice Address - Country:US
Practice Address - Phone:671-649-8638
Practice Address - Fax:671-648-5463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty