Healthcare Provider Details

I. General information

NPI: 1548358393
Provider Name (Legal Business Name): WAYNE B L CHUN MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 S BERETANIA ST STE J
HONOLULU HI
96814-1825
US

IV. Provider business mailing address

1351 S BERETANIA ST STE J
HONOLULU HI
96814-1825
US

V. Phone/Fax

Practice location:
  • Phone: 808-852-8289
  • Fax:
Mailing address:
  • Phone: 808-852-8289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD 8858
License Number StateHI

VIII. Authorized Official

Name: WAYNE B.L. CHUN
Title or Position: OWNER
Credential: M.D.
Phone: 808-852-8289