Healthcare Provider Details

I. General information

NPI: 1689709206
Provider Name (Legal Business Name): LADONNA CHUNG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LADONNA SIMONEAU M.D.

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/15/2014
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

P.O. BOX 17624
HONOLULU HI
96817
US

V. Phone/Fax

Practice location:
  • Phone: 808-547-9548
  • Fax: 808-547-9718
Mailing address:
  • Phone: 808-547-9548
  • Fax: 808-547-9718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD 15671
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number15671
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: