Organization Name: | EXPRESSCARE HEALTH AND SKIN CENTER INC. |
NPI Number: | 1538544713 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JITKA LOM (PRESIDENT) |
Mailing Address: | 302 South Route 4 Suite 207 Hagatna |
State: | GU US |
Postal Code: | 96932 |
Phone Number: | 6714772873 |
Fax Number: | 6714722873 |
NPI Enumeration Date: | 07/29/2015 |
NPI Last Update Date: | 08/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0000X |
License Number: | M1288 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GU |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adolescent Medicine |
Taxonomy Definition: | A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |