Healthcare Provider Details

I. General information

NPI: 1336217405
Provider Name (Legal Business Name): NUCLEAR MEDICINE ASSOCIATES OF HAWAII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 N KUAKINI ST
HONOLULU HI
96817-2336
US

IV. Provider business mailing address

1408 OHIALOKE ST
HONOLULU HI
96821-1412
US

V. Phone/Fax

Practice location:
  • Phone: 808-547-9549
  • Fax: 808-547-9554
Mailing address:
  • Phone: 808-547-9549
  • Fax: 808-547-9554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberMD-5191
License Number StateHI

VIII. Authorized Official

Name: DR. MICHAEL CHAO CHI LING
Title or Position: MEMBER
Credential: M.D.
Phone: 808-547-9549