MEDICARE: FUCHAT CHAN M.D.

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	208000000X	Pediatrics Physician	3276	HI
2	208000000X	Pediatrics Physician	A34951	CA
3	208000000X	Pediatrics Physician	MD00018470	WA
4	2080P0214X	Pediatric Pulmonology Physician	3276	HI

General Provider Information

NPI Number	:	1033147335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FUCHAT CHAN M.D.

Provider Business Mailing Address
First Line	:	91-2139 FT. WEAVER RD., #102
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-3608
Country	:	US
Telephone Number	:	808-671-6777
Fax Number	:

Provider Business Practice Location Address
First Line	:	91-2139 FT. WEAVER RD., #102
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-3608
Country	:	US
Telephone Number	:	808-671-6777
Fax Number	:

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	09/11/2025

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