Healthcare Provider Details

I. General information

NPI: 1548002033
Provider Name (Legal Business Name): MEGUMI HOMMA DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 N MARINE CORPS DR STE 110
TAMUNING GU
96913-4426
US

IV. Provider business mailing address

285 FARENHOLT AVE STE 303 PMB 1941
TAMUNING GU
96913
US

V. Phone/Fax

Practice location:
  • Phone: 671-649-9355
  • Fax:
Mailing address:
  • Phone: 323-246-3166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC37140
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberC-48
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: