Provider Demographics
NPI:1245599620
Name:LINDA L NGUYEN
Entity Type:Organization
Organization Name:LINDA L NGUYEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:808-877-7828
Mailing Address - Street 1:74 LONO AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-1626
Mailing Address - Country:US
Mailing Address - Phone:808-877-7828
Mailing Address - Fax:808-877-7611
Practice Address - Street 1:74 LONO AVE STE 101
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1626
Practice Address - Country:US
Practice Address - Phone:808-877-7828
Practice Address - Fax:808-877-7611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI633152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty