1891797684 NPI number — DR. TONY L NGUYEN PHARMD

Table of content: DR. TONY L NGUYEN PHARMD (NPI 1891797684)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891797684 NPI number — DR. TONY L NGUYEN PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NGUYEN
Provider First Name:
TONY
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891797684
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
46-065 KONOHIKI ST
Provider Second Line Business Mailing Address:
3666
Provider Business Mailing Address City Name:
KANEOHE
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96744-6132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-554-8301
Provider Business Mailing Address Fax Number:
808-432-3854

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45-602 KAMEHAMEHA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANEOHE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96744-2017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-432-3853
Provider Business Practice Location Address Fax Number:
808-432-3854
Provider Enumeration Date:
08/11/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PH-1194 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183500000X , with the licence number: RPH38998 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)