Healthcare Provider Details

I. General information

NPI: 1689644502
Provider Name (Legal Business Name): CHEN-YEN WANG, N.P. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N BERETANIA ST SUITE 214
HONOLULU HI
96817-4712
US

IV. Provider business mailing address

1702 KEWALO ST APT 1103
HONOLULU HI
96822-3034
US

V. Phone/Fax

Practice location:
  • Phone: 808-550-5686
  • Fax: 808-550-5684
Mailing address:
  • Phone: 808-538-8792
  • Fax: 808-550-5684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN-197
License Number StateHI

VIII. Authorized Official

Name: DR. CHEN YEN GRACE WANG
Title or Position: PRESIDENT
Credential: N.P.
Phone: 808-550-5868