=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417593831
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHAD LM AHIA MD, MPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/20/2019
-----------------------------------------------------
Last Update Date | 05/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 28-1680 OLD MAMALAHOA HWY UNIT A
-----------------------------------------------------
City | HONOMU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-238-0232
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 352
-----------------------------------------------------
City | HONOMU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96728-0352
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD-23044
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------