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General NPI Number Information
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NPI Number | 1114109071
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Entity Type | Individual
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Provider Name | TIMOTHY TRUNG NGUYEN LAC., DIPL. OM
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Gender | Male
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 02/27/2018
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Provider Practice Location Address
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Address Line | 1150 S KING ST STE 302
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City | HONOLULU
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State | HI
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Zip | 96814-1951
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Country | US
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Telephone | 808-319-7791
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Fax | 808-200-0567
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Provider Business Mailing Address
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Address Line | 600 ALA MOANA BLVD APT 2502
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City | HONOLULU
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State | HI
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Zip | 96813-4959
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Country | US
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Telephone | 808-319-7791
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Fax | 808-200-0567
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC11658
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | ACU1213
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License Number State | HI
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