Provider Demographics
NPI:1174864078
Name:DR. IAN NUI CHUN LLC
Entity Type:Organization
Organization Name:DR. IAN NUI CHUN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:NUI
Authorized Official - Last Name:CHUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-220-8914
Mailing Address - Street 1:PO BOX 4157
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-0157
Mailing Address - Country:US
Mailing Address - Phone:808-220-8914
Mailing Address - Fax:
Practice Address - Street 1:2649 WAIANUHEA PL
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-5685
Practice Address - Country:US
Practice Address - Phone:808-220-8914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW37447900-01261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)