Provider Demographics
NPI:1073563979
Name:CHOU, DAVID SHU- AN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SHU- AN
Last Name:CHOU
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 1:1029 KAPAHULU AVE
Mailing Address - Street 2:STE 306
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1332
Mailing Address - Country:US
Mailing Address - Phone:808-218-7857
Mailing Address - Fax:808-218-7859
Practice Address - Street 1:1029 KAPAHULU AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1332
Practice Address - Country:US
Practice Address - Phone:808-218-7858
Practice Address - Fax:808-218-7859
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD12959208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI553611-01Medicaid
HIMD12959OtherHAWAII LICENSE NUMBER
HI553611-01Medicaid
HIH98015Medicare UPIN