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General NPI Number Information
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NPI Number | 1407145444
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Entity Type | Organization
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Legal Business Name | GRANT L Y CHEN MD LLC
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 09/08/2016
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Provider Practice Location Address
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Address Line | 1301 PUNCHBOWL ST
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City | HONOLULU
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State | HI
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Zip | 96813-2402
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Country | US
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Telephone | 808-255-6229
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Fax | 808-537-1952
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Provider Business Mailing Address
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Address Line | 848 S BERETANIA ST STE 408
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City | HONOLULU
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State | HI
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Zip | 96813-2551
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Country | US
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Telephone | 808-859-3628
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Fax | 808-537-1952
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | DR. GRANT L Y CHEN
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Credential | M.D.
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Telephone | 808-255-6229
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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 | 14305
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License Number State | HI
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