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General NPI Number Information
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NPI Number | 1407159858
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Entity Type | Organization
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Legal Business Name | HIPPOCRATES SLEEP DISORDER DIAGNOSTIC CENTER
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 1 NAURU LOOP DRIVE, 402 MARIANAS BUSINESS PLAZA
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City | SAIPAN
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State | MP
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Zip | 96950-2213
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Country | US
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Telephone | 670-234-8005
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Fax | 670-234-8028
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Provider Business Mailing Address
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Address Line | 1 NAURU LOOP DRIVE, 402 MARIANAS BUSINESS PLAZA P.O. BOX 502213
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City | SAIPAN
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State | MP
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Zip | 96950-2213
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Country | US
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Telephone | 670-234-8005
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Fax | 670-234-8028
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Authorized Official
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Title or Position | C.E.O.
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Name | DR. JOHNNY YEE FONG
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Credential | M.D.
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Telephone | 670-234-8005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number | 1759500031
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License Number State | MP
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