Healthcare Provider Details

I. General information

NPI: 1316072267
Provider Name (Legal Business Name): LETICIA PANGELINAN BORJA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LOWER NAVY HILL COMMONWEALTH HEALTH CENTER
SAIPAN MP
96950
US

IV. Provider business mailing address

PO BOX 500275
SAIPAN MP
96950
US

V. Phone/Fax

Practice location:
  • Phone: 670-234-8950
  • Fax: 670-236-8600
Mailing address:
  • Phone: 670-288-8848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0394
License Number StateMP

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: