Healthcare Provider Details

I. General information

NPI: 1164954608
Provider Name (Legal Business Name): HEATH H. CHUNG, MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ALA MOANA BLVD 5-300
HONOLULU HI
96813-4920
US

IV. Provider business mailing address

PO BOX 37056
HONOLULU HI
96837-0056
US

V. Phone/Fax

Practice location:
  • Phone: 808-531-7111
  • Fax: 808-528-5507
Mailing address:
  • Phone: 808-228-5436
  • Fax: 808-528-5507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. TANYA FLORIN
Title or Position: BILLING MANAGER
Credential:
Phone: 808-228-5436