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General NPI Number Information
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NPI Number | 1134231095
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Entity Type | Organization
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Legal Business Name | HEATH H CHUNG MD LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 1329 LUSITANA ST
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City | HONOLULU
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State | HI
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Zip | 96813-2429
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Country | US
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Telephone | 808-531-7111
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Fax | 808-528-5507
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Provider Business Mailing Address
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Address Line | PO BOX 37056
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City | HONOLULU
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State | HI
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Zip | 96837-0056
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Country | US
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Telephone | 808-225-0263
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Fax | 808-528-5507
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Authorized Official
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Title or Position | PRESIDENT
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Name | HEATH H CHUNG
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Credential | M.D.
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Telephone | 808-225-5432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 13906
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License Number State | HI
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