MEDICARE: DR. DOMINIC CHOW M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD-10791	HI
2	207R00000X	Internal Medicine Physician	MD-10791	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063464972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOMINIC CHOW M.D.

Provider Business Mailing Address
First Line	:	651 ILALO ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-5525
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	651 ILALO ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-5525
Country	:	US
Telephone Number	:	808-692-0899
Fax Number	:	808-692-1247

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	02/28/2020

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Directions to “ DR. DOMINIC CHOW M.D.” Practice Location

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