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General NPI Number Information
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NPI Number | 1437697166
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Entity Type | Organization
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Legal Business Name | OPHTHALMOLOGY CONSULTANTS OF OAHU, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6600 KALANIANAOLE HWY STE 114C
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City | HONOLULU
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State | HI
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Zip | 96825-1273
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Country | US
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Telephone | 808-373-9373
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Fax | 808-373-9370
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Provider Business Mailing Address
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Address Line | 6600 KALANIANAOLE HWY STE 114C
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City | HONOLULU
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State | HI
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Zip | 96825-1273
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Country | US
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Telephone | 808-373-9373
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Fax | 808-373-9370
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH CHANG
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Credential | MD, MPH
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Telephone | 808-375-3669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 17620
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License Number State | HI
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