Provider Demographics
NPI:1649383415
Name:NOGUCHI, GARRET K (DPM)
Entity type:Individual
Prefix:DR
First Name:GARRET
Middle Name:K
Last Name:NOGUCHI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N KUAKINI ST STE 801
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2362
Mailing Address - Country:US
Mailing Address - Phone:808-521-2002
Mailing Address - Fax:808-521-0351
Practice Address - Street 1:321 N KUAKINI ST STE 801
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2362
Practice Address - Country:US
Practice Address - Phone:808-521-2002
Practice Address - Fax:808-521-0351
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPO131213EP1101X, 213ER0200X, 213ES0000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Not Answered213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
Not Answered213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Not Answered213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI210765OtherHMSA, HI
HI192704OtherHMA, INC
HI08079401Medicaid
HI50004Medicare ID - Type Unspecified
HI1308000001Medicare ID - Type UnspecifiedCIGNA/DME
HIU66089Medicare UPIN