Healthcare Provider Details

I. General information

NPI: 1699006544
Provider Name (Legal Business Name): CHELSEA CHING-ENDOW MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 KAPAHULU AVE SUITE 300
HONOLULU HI
96816-1332
US

IV. Provider business mailing address

1029 KAPAHULU AVE SUITE 300
HONOLULU HI
96816-1332
US

V. Phone/Fax

Practice location:
  • Phone: 808-733-5111
  • Fax: 808-733-5122
Mailing address:
  • Phone: 808-733-5111
  • Fax: 808-733-5122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD14571
License Number StateHI

VIII. Authorized Official

Name: CHELSEA KFY CHING-ENDOW
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 808-729-9090