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General NPI Number Information
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NPI Number | 1730537580
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Entity Type | Organization
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Legal Business Name | LISA NGUYEN MD LLC
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Dates
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Enumeration Date | 06/01/2016
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 1188 BISHOP ST STE 1102
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City | HONOLULU
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State | HI
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Zip | 96813-3304
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Country | US
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Telephone | 850-888-8598
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Fax |
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Provider Business Mailing Address
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Address Line | 1170 NUUANU AVE UNIT 38164
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City | HONOLULU
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State | HI
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Zip | 96837-5648
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | LISA NGUYEN
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Credential |
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Telephone | 850-888-8598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD 18530
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License Number State | HI
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