Healthcare Provider Details

I. General information

NPI: 1679898571
Provider Name (Legal Business Name): DANA MICHELLE GUGGENHEIM L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2010
Last Update Date: 04/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67-216 FARRINGTON HWY STE 202
WAIALUA HI
96791-9671
US

IV. Provider business mailing address

66216 FARRINGTON HWY. STE 202
WAIALUA HI
96791
US

V. Phone/Fax

Practice location:
  • Phone: 808-637-4880
  • Fax: 808-637-4880
Mailing address:
  • Phone: 808-637-4880
  • Fax: 808-637-4880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number908
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: