Healthcare Provider Details

I. General information

NPI: 1710413232
Provider Name (Legal Business Name): TRUDY M. HONG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2017
Last Update Date: 05/16/2024
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-151 PALI MOMI ST STE 142
AIEA HI
96701-4333
US

IV. Provider business mailing address

98-151 PALI MOMI ST STE 142
AIEA HI
96701-4333
US

V. Phone/Fax

Practice location:
  • Phone: 808-483-6400
  • Fax: 808-483-6487
Mailing address:
  • Phone: 808-483-6400
  • Fax: 808-483-6082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD-21088
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: