Healthcare Provider Details
I. General information
NPI: 1588832349
Provider Name (Legal Business Name): GEORGE J. CHU
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/14/2008
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1329 LUSITANA ST STE 102
HONOLULU HI
96813-2401
US
IV. Provider business mailing address
1329 LUSITANA ST STE 102
HONOLULU HI
96813-2401
US
V. Phone/Fax
- Phone: 808-532-1311
- Fax: 808-536-2224
- Phone: 808-532-1311
- Fax: 808-536-2224
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | 3268 |
| License Number State | HI |
VIII. Authorized Official
Name: DR.
GEORGE
J
CHU
Title or Position: PROPRIETOR
Credential: MD
Phone: 808-532-1311