Healthcare Provider Details

I. General information

NPI: 1164609517
Provider Name (Legal Business Name): SUSIE A CHEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2226 LILIHA ST STE B2
HONOLULU HI
96817-1605
US

IV. Provider business mailing address

2226 LILIHA ST STE 300
HONOLULU HI
96817-1605
US

V. Phone/Fax

Practice location:
  • Phone: 808-744-6187
  • Fax: 808-744-6958
Mailing address:
  • Phone: 808-744-6187
  • Fax: 808-744-6958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberHI17423
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: