Provider Demographics
NPI:1164950523
Name:PHAM, SEAN THANG NGUYEN (DO)
Entity type:Individual
Prefix:DR
First Name:SEAN THANG
Middle Name:NGUYEN
Last Name:PHAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 OHOHIA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1935
Mailing Address - Country:US
Mailing Address - Phone:808-831-3000
Mailing Address - Fax:808-834-5763
Practice Address - Street 1:545 OHOHIA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1935
Practice Address - Country:US
Practice Address - Phone:808-831-3000
Practice Address - Fax:808-834-5763
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS-2455207Q00000X
WAOP61299466207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty