Provider Demographics
NPI:1093083362
Name:ASIA PACIFIC SURGERY, LLC
Entity Type:Organization
Organization Name:ASIA PACIFIC SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-585-8855
Mailing Address - Street 1:1401 SOUTH BERETANIA STREET
Mailing Address - Street 2:#888
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1875
Mailing Address - Country:US
Mailing Address - Phone:808-585-8855
Mailing Address - Fax:808-532-8880
Practice Address - Street 1:1401 SOUTH BERETANIA STREET
Practice Address - Street 2:#888
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1875
Practice Address - Country:US
Practice Address - Phone:808-585-8855
Practice Address - Fax:808-532-8880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI129272086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0056984001Medicaid
HI0056984001Medicaid