Provider Demographics
NPI:1376552554
Name:CHUN, MICHAEL KY (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:KY
Last Name:CHUN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-1079 MOANALUA RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4713
Mailing Address - Country:US
Mailing Address - Phone:808-488-8101
Mailing Address - Fax:808-488-8389
Practice Address - Street 1:98-1079 MOANALUA RD
Practice Address - Street 2:SUITE 400
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4713
Practice Address - Country:US
Practice Address - Phone:808-488-8101
Practice Address - Fax:808-488-8389
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPO100213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI6449-3OtherHMSA PROVIDER #
HI05606601Medicaid
HI6449-3OtherHMSA PROVIDER #
HIU11388Medicare UPIN
HI0831480001Medicare NSC