Provider Demographics
NPI:1467936195
Name:WESTPAC HEMATOLOGY & ONCOLOGY CENTER INC
Entity type:Organization
Organization Name:WESTPAC HEMATOLOGY & ONCOLOGY CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:CONCEPCION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-647-4656
Mailing Address - Street 1:633 GOV CARLOS CAMACHO RD STE B5
Mailing Address - Street 2:
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 1:633 GOV CARLOS CAMACHO RD STE B5
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3194
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:2018-09-19
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GUM-1925OtherGUAM MEDICAL BOARD LICENSE