Provider Demographics
NPI:1033424528
Name:ONG, ANTONIO CHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:CHAN
Last Name:ONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 LUNALILO HOME RD
Mailing Address - Street 2:UNIT # 7112
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1700
Mailing Address - Country:US
Mailing Address - Phone:808-394-8788
Mailing Address - Fax:808-394-8788
Practice Address - Street 1:520 LUNALILO HOME RD
Practice Address - Street 2:UNIT # 7112
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1700
Practice Address - Country:US
Practice Address - Phone:808-394-8788
Practice Address - Fax:808-394-8788
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI14602174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist