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General NPI Number Information
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NPI Number | 1487031613
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Entity Type | Organization
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Legal Business Name | OFFICE OF LEOPOLDO ARCILLA , JR.,MD.,PC
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 04/27/2015
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Provider Practice Location Address
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Address Line | 1757 ARMY DR STE 108
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City | TAMUNING
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State | GU
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Zip | 96913-1260
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Country | US
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Telephone | 671-647-4533
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Fax | 671-647-1110
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Provider Business Mailing Address
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Address Line | 1757 ARMY DR STE 108
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City | TAMUNING
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State | GU
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Zip | 96913-1260
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Country | US
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Telephone | 671-647-4533
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Fax | 671-647-1110
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | DR. LEOPOLDO CLAVA ARCILLA JR.
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Credential | MD
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Telephone | 671-483-6766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | M-1565
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License Number State | GU
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