Healthcare Provider Details

I. General information

NPI: 1093914897
Provider Name (Legal Business Name): SHAYLIN P.Y.K. CHOCK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 01/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1356 LUSITANA ST 4TH FL.
HONOLULU HI
96813-2409
US

IV. Provider business mailing address

1356 LUSITANA ST 4TH FL.
HONOLULU HI
96813-2409
US

V. Phone/Fax

Practice location:
  • Phone: 808-586-2900
  • Fax:
Mailing address:
  • Phone: 808-586-2900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA107273
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA107273
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberA107273
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD-17320
License Number StateHI
# 5
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD-17320
License Number StateHI
# 6
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberMD-17320
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: