Provider Demographics
NPI:1407044118
Name:HAWAII VEIN INSTITUTE, LLC
Entity Type:Organization
Organization Name:HAWAII VEIN INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:WOOYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-949-8346
Mailing Address - Street 1:1585 KAPIOLANI BLVD STE 1740
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4532
Mailing Address - Country:US
Mailing Address - Phone:808-949-8346
Mailing Address - Fax:
Practice Address - Street 1:1585 KAPIOLANI BLVD STE 1740
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4532
Practice Address - Country:US
Practice Address - Phone:808-949-8346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
202K00000X
HI261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty