Healthcare Provider Details

I. General information

NPI: 1770928038
Provider Name (Legal Business Name): CHI NGA CHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-2141 FORT WEAVER RD
EWA BEACH HI
96706-1993
US

IV. Provider business mailing address

500 UNIVERSITY AVE APT 119
HONOLULU HI
96826-4905
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-3000
  • Fax:
Mailing address:
  • Phone: 808-497-1120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD-18542
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: