Healthcare Provider Details

I. General information

NPI: 1396014031
Provider Name (Legal Business Name): EUGENE W M NG MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2011
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 PIIKOI ST STE 1210
HONOLULU HI
96814-3141
US

IV. Provider business mailing address

P.O. BOX 1300 MSC 61329
HONOLULU HI
96807-1300
US

V. Phone/Fax

Practice location:
  • Phone: 808-356-3820
  • Fax: 808-356-3920
Mailing address:
  • Phone: 808-356-3820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberMD-15409
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD-15409
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberMD-15409
License Number StateHI

VIII. Authorized Official

Name: EUGENE NG
Title or Position: OWNER
Credential:
Phone: 808-356-3820