Healthcare Provider Details

I. General information

NPI: 1376552554
Provider Name (Legal Business Name): MICHAEL K.Y. CHUN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1079 MOANALUA RD SUITE 400
AIEA HI
96701-4713
US

IV. Provider business mailing address

98-1079 MOANALUA RD SUITE 400
AIEA HI
96701-4713
US

V. Phone/Fax

Practice location:
  • Phone: 808-488-8101
  • Fax: 808-488-8389
Mailing address:
  • Phone: 808-488-8101
  • Fax: 808-488-8389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO100
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPO100
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: