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General NPI Number Information
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NPI Number | 1144309576
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Entity Type | Individual
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Provider Name | CLAYTON CHAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/05/2006
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 45-1144 KAMEHAMEHA HWY STE 300
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City | KANEOHE
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State | HI
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Zip | 96744-3245
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Country | US
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Telephone | 808-371-1311
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Fax |
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Provider Business Mailing Address
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Address Line | 45-1144 KAMEHAMEHA HWY STE 300
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City | KANEOHE
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State | HI
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Zip | 96744-3245
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Country | US
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Telephone | 808-371-1311
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD - 8451
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License Number State | HI
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