Healthcare Provider Details

I. General information

NPI: 1477477461
Provider Name (Legal Business Name): SONGCHEN XU D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 KAMOKILA BLVD STE 207
KAPOLEI HI
96707-2055
US

IV. Provider business mailing address

338 KAMOKILA BLVD STE 207
KAPOLEI HI
96707-2055
US

V. Phone/Fax

Practice location:
  • Phone: 808-321-1540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-1666-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: