Provider Demographics
NPI:1679862809
Name:NGUYEN, PHUONG D (ND)
Entity Type:Individual
Prefix:DR
First Name:PHUONG
Middle Name:D
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-1277 KAAHUMANU ST STE 142
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5319
Mailing Address - Country:US
Mailing Address - Phone:084-503-0898
Mailing Address - Fax:
Practice Address - Street 1:98-1277 KAAHUMANU ST STE 142
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5319
Practice Address - Country:US
Practice Address - Phone:808-450-3089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIND229207Q00000X
HIND-229175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty