Healthcare Provider Details

I. General information

NPI: 1326580168
Provider Name (Legal Business Name): CHRISTOPHER CHUR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2016
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1760 HAPAKI ST
AIEA HI
96701-1630
US

IV. Provider business mailing address

98-1760 HAPAKI ST
AIEA HI
96701-1630
US

V. Phone/Fax

Practice location:
  • Phone: 808-223-0192
  • Fax:
Mailing address:
  • Phone: 808-223-0192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC-826
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-16-25705
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: