=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528284684
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WEI CHAO, M.D., LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2007
-----------------------------------------------------
Last Update Date | 01/09/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1253 S BERETANIA ST SUITE 2325
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96814-1822
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-735-9093
-----------------------------------------------------
Fax | 808-732-6647
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1253 S BERETANIA ST SUITE 2325
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96814-1822
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-735-9093
-----------------------------------------------------
Fax | 808-732-6647
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. WEI CHAO
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 808-735-9093
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | MD7896
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------