Provider Demographics
NPI:1265510895
Name:BENTON H.H. CHUN, M.D., INC.
Entity Type:Organization
Organization Name:BENTON H.H. CHUN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENTON
Authorized Official - Middle Name:HH
Authorized Official - Last Name:CHUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-523-8868
Mailing Address - Street 1:1329 LUSITANA ST
Mailing Address - Street 2:SUITE 607
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2429
Mailing Address - Country:US
Mailing Address - Phone:808-523-8868
Mailing Address - Fax:808-537-5500
Practice Address - Street 1:1329 LUSITANA ST
Practice Address - Street 2:SUITE 607
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2429
Practice Address - Country:US
Practice Address - Phone:808-523-8868
Practice Address - Fax:808-537-5500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3781207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000049841OtherHMSA PROVIDER #
HI044670Medicaid
HI0000049841OtherBLUE CROSS PROVIDER #
HI0000049841OtherFEP PROVIDER #
HIMD3781OtherMDX HAWAII PROVIDER #
HI044670Medicaid
HI0000049841OtherFEP PROVIDER #