MEDICARE: DR. JONATHAN CHEONG GOCHU 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	174400000X	Specialist	209302	NY
2	207RG0100X	Gastroenterology Physician	15191	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	:	1629058987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN CHEONG GOCHU M.D.

Provider Business Mailing Address
First Line	:	888 SOUTH KING STREET
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813
Country	:	US
Telephone Number	:	808-522-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	888 S KING ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-3097
Country	:	US
Telephone Number	:	808-522-4000
Fax Number	:

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

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	07/19/2011

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