MEDICARE: SUZETTE GUILLERMO TIANGCO RN, CDCES

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	163WD0400X	Diabetes Educator Registered Nurse	32309949	HI

General Provider Information

NPI Number	:	1497641443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZETTE GUILLERMO TIANGCO RN, CDCES

Provider Business Mailing Address
First Line	:	1706 NOE ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96819-3852
Country	:	US
Telephone Number	:	808-636-5052
Fax Number	:

Provider Business Practice Location Address
First Line	:	1380 LUSITANA ST STE B-5
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-2449
Country	:	US
Telephone Number	:	808-691-4823
Fax Number	:	808-691-5399

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

Provider Enumeration Date	:	06/16/2025
Last Update Date	:	09/23/2025

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