Provider Demographics
NPI:1275633034
Name:FUKUI, CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:FUKUI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 HALAKI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-2102
Mailing Address - Country:US
Mailing Address - Phone:808-728-4189
Mailing Address - Fax:
Practice Address - Street 1:1 JARRETT WHITE ROAD
Practice Address - Street 2:TRIPLER ARMY MEDICAL CENTER
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96859
Practice Address - Country:US
Practice Address - Phone:808-433-6014
Practice Address - Fax:808-433-5746
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-3974207RP1001X
HI3974207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI046529-01Medicaid
HI00X0052899OtherHMSA BILLING NUMBER
HIC97394Medicare UPIN
HI00X0052899OtherHMSA BILLING NUMBER