Provider Demographics
NPI:1376621318
Name:CHEN, MING (MD)
Entity Type:Individual
Prefix:DR
First Name:MING
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 S KUKUI ST
Mailing Address - Street 2:STE C109
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813
Mailing Address - Country:US
Mailing Address - Phone:808-531-8874
Mailing Address - Fax:808-523-0466
Practice Address - Street 1:55 S KUKUI ST
Practice Address - Street 2:STE C109
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813
Practice Address - Country:US
Practice Address - Phone:808-531-8874
Practice Address - Fax:808-523-0466
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI03595207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000051805OtherHMSA
HI0000051805OtherQUEST
HI0771640001OtherCIGNA MEDICARE
HI04558301Medicaid
HIH0000BDHDQMedicare ID - Type Unspecified
D91048Medicare UPIN