Healthcare Provider Details

I. General information

NPI: 1689503856
Provider Name (Legal Business Name): ANTHONY GALBIS MENDIOLA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 ROUTE 8
MAITE GU
96910-3001
US

IV. Provider business mailing address

PO BOX 326215
HAGATNA GU
96932-6003
US

V. Phone/Fax

Practice location:
  • Phone: 671-477-5091
  • Fax: 671-477-2464
Mailing address:
  • Phone: 671-477-5091
  • Fax: 671-477-2464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: