Healthcare Provider Details

I. General information

NPI: 1114036811
Provider Name (Legal Business Name): RONALD Y S CHOCK MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 10/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N KUAKINI ST #512
HONOLULU HI
96817-2364
US

IV. Provider business mailing address

321 N KUAKINI ST #512
HONOLULU HI
96817-2364
US

V. Phone/Fax

Practice location:
  • Phone: 808-537-2895
  • Fax: 808-537-2010
Mailing address:
  • Phone: 808-537-2895
  • Fax: 808-537-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number5074
License Number StateHI

VIII. Authorized Official

Name: DR. RONALD CHOCK
Title or Position: PRESIDENT
Credential: M.D
Phone: 808-537-2895