Provider Demographics
NPI:1699772616
Name:NGUYEN, LINDA (OD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 PAA ST
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-3605
Mailing Address - Country:US
Mailing Address - Phone:808-877-7828
Mailing Address - Fax:808-442-9746
Practice Address - Street 1:32 PAA ST
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-3605
Practice Address - Country:US
Practice Address - Phone:808-877-7828
Practice Address - Fax:808-442-9764
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI633152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIV08298Medicare UPIN