Healthcare Provider Details

I. General information

NPI: 1144310723
Provider Name (Legal Business Name): MEDICAL ASSOCIATES OF THE PACIFIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MARINA HEIGHTS BUSINESS PARK SUITE 100
SAIPAN MP
96950-0938
US

IV. Provider business mailing address

PO BOX 500938 MARINA HEIGHTS BUSINESS PARK SUITE 100
SAIPAN MP
96950-0938
US

V. Phone/Fax

Practice location:
  • Phone: 670-323-9000
  • Fax: 670-323-9010
Mailing address:
  • Phone: 670-323-9000
  • Fax: 670-323-9010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0220
License Number StateMP

VIII. Authorized Official

Name: NORMA S ADA
Title or Position: SOLE OWNER
Credential: MD
Phone: 670-323-9000