Healthcare Provider Details

I. General information

NPI: 1770167066
Provider Name (Legal Business Name): LINDA INGRIDSON GAMO GOUGUE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA GAMO MD

II. Dates (important events)

Enumeration Date: 05/12/2021
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PUNCHBOWL ST
HONOLULU HI
96813-2402
US

IV. Provider business mailing address

770 KAPIOLANI BLVD STE 705
HONOLULU HI
96813-5241
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-4311
  • Fax:
Mailing address:
  • Phone: 808-597-8799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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: