Healthcare Provider Details

I. General information

NPI: 1972720241
Provider Name (Legal Business Name): CHRISTINA J. WAI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 04/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-2135 FORT WEAVER RD STE 150
EWA BEACH HI
96706-1929
US

IV. Provider business mailing address

677 ALA MOANA BLVD STE 1001
HONOLULU HI
96813-5408
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-3177
  • Fax: 808-691-3195
Mailing address:
  • Phone: 408-469-4900
  • Fax: 808-587-9507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD442112
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number052326
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number052326
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberMD20241
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: