MEDICARE: JEFFREY H NGUYEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	MD-26890-0	HI
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1083309355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY H NGUYEN MD

Provider Business Mailing Address
First Line	:	1356 LUSITANA ST FL 7
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-2409
Country	:	US
Telephone Number	:	808-691-4970
Fax Number	:

Provider Business Practice Location Address
First Line	:	1356 LUSITANA ST FL 7
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-2409
Country	:	US
Telephone Number	:	808-691-4970
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2023
Last Update Date	:	04/13/2026

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