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General NPI Number Information
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NPI Number | 1447611181
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Entity Type | Individual
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Provider Name | LORRAINE S. SUNGA O.D.
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Gender | Female
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Dates
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Enumeration Date | 03/08/2016
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 302 ROUTE 4 STE 105
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City | HAGATNA
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State | GU
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Zip | 96910-4301
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Country | US
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Telephone | 671-475-8090
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Fax |
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Provider Business Mailing Address
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Address Line | 302 ROUTE 4 STE 105
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City | HAGATNA
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State | GU
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Zip | 96910-4301
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Country | US
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Telephone | 671-475-8090
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OL-036
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License Number State | GU
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