Individual
EDISON PINEDA MANALOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
133 ROUTE 3, DEDEDO, GU 96929-6911
(671) 645-5500
Mailing address
133 ROUTE 3, DEDEDO, GU 96929-6911
(671) 645-5500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M-2208
GU
208M00000X
Hospitalist Physician
Primary
M-2208
GU
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2017
Last updated
07/01/2020
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