Healthcare Provider Details

I. General information

NPI: 1801292099
Provider Name (Legal Business Name): HONOLULU ENDOCRINOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2014
Last Update Date: 10/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 LUSITANA ST STE 902
HONOLULU HI
96813-2448
US

IV. Provider business mailing address

1380 LUSITANA ST STE 902
HONOLULU HI
96813-2448
US

V. Phone/Fax

Practice location:
  • Phone: 808-524-2472
  • Fax: 808-537-5698
Mailing address:
  • Phone: 808-524-2472
  • Fax: 808-537-5698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number17896
License Number StateHI

VIII. Authorized Official

Name: EMILY YAP CHAN
Title or Position: PRESIDENT
Credential: MD
Phone: 916-529-2199