Healthcare Provider Details

I. General information

NPI: 1922129428
Provider Name (Legal Business Name): JULIE N TRINH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45-710 KEAAHALA RD
KANEOHE HI
96744-3528
US

IV. Provider business mailing address

45-710 KEAAHALA RD
KANEOHE HI
96744-3528
US

V. Phone/Fax

Practice location:
  • Phone: 808-247-2191
  • Fax: 808-236-8454
Mailing address:
  • Phone: 808-247-2191
  • Fax: 808-236-8454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberMD12209
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: