MEDICARE: MANU'A MEDICAL CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QC1500X	Community Health Clinic/Center
2	261QH0100X	Health Service Clinic/Center
3	261QM1102X	Military Outpatient Operational (Transportable) Component Clinic/Center
4	261QM1103X	Military Ambulatory Procedure Visits Operational (Transportable) Clinic/Center
5	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center
6	261QM1300X	Multi-Specialty Clinic/Center
7	261QP2300X	Primary Care Clinic/Center
8	261QR0208X	Mobile Radiology Clinic/Center
9	261QR1100X	Research Clinic/Center
10	261QU0200X	Urgent Care Clinic/Center
11	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1467835124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANU'A MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	8033 W SUNSET BLVD STE 588
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90046-2401
Country	:	US
Telephone Number	:	323-892-2300
Fax Number	:	323-892-2307

Provider Business Practice Location Address
First Line	:	98-2925 TUITASI FARM ROAD
Second Line	:	MALAELOA-AITULAGI
City	:	PAGO PAGO
State	:	AS
Zip	:	96799
Country	:	US
Telephone Number	:	684-688-9968
Fax Number	:	323-892-2307

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	MR. BARNEY SENE
Credential	:
Telephone Number	:	213-892-2300

Provider Enumeration Date	:	06/30/2015
Last Update Date	:	06/30/2015

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