=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164609517
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUSIE A CHEN M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2008
-----------------------------------------------------
Last Update Date | 06/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2226 LILIHA ST STE B2
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96817-1605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-744-6187
-----------------------------------------------------
Fax | 808-744-6958
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2226 LILIHA ST STE 300
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96817-1605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-744-6187
-----------------------------------------------------
Fax | 808-744-6958
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0001X
-----------------------------------------------------
Taxonomy Name | Radiation Oncology Physician
-----------------------------------------------------
License Number | HI17423
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------