Healthcare Provider Details

I. General information

NPI: 1821356247
Provider Name (Legal Business Name): MARIANA L.G. COOK-HUYNH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 10/12/2025
Certification Date: 10/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 N MARINE CORPS DR STE 121
TAMUNING GU
96913-4426
US

IV. Provider business mailing address

744 N MARINE CORPS DR STE 121
TAMUNING GU
96913-4426
US

V. Phone/Fax

Practice location:
  • Phone: 671-588-2394
  • Fax:
Mailing address:
  • Phone: 671-588-2394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM1970
License Number StateGU
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: