Healthcare Provider Details

I. General information

NPI: 1750185963
Provider Name (Legal Business Name): CHAD AHIA MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64-1032 MAMALAHOA HWY UNIT A
HONOMU HI
96728
US

IV. Provider business mailing address

PO BOX 352
HONOMU HI
96728-0352
US

V. Phone/Fax

Practice location:
  • Phone: 808-238-0082
  • Fax:
Mailing address:
  • Phone: 808-238-0082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHAD LM AHIA
Title or Position: MANAGER
Credential: MD, MPH
Phone: 808-430-8602