Provider Demographics
NPI:1417025818
Name:SUKCHAI SATTA MD, INC.
Entity Type:Organization
Organization Name:SUKCHAI SATTA MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ITS PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUKCHAI
Authorized Official - Middle Name:
Authorized Official - Last Name:SATTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-322-9324
Mailing Address - Street 1:PO BOX 9003
Mailing Address - Street 2:
Mailing Address - City:KEALAKEKUA
Mailing Address - State:HI
Mailing Address - Zip Code:96750-9003
Mailing Address - Country:US
Mailing Address - Phone:808-322-9324
Mailing Address - Fax:808-322-9234
Practice Address - Street 1:79-7266 MAMALAHOA HWY
Practice Address - Street 2:SUITE 2
Practice Address - City:KEALAKEKUA
Practice Address - State:HI
Practice Address - Zip Code:96750-7919
Practice Address - Country:US
Practice Address - Phone:808-322-9324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03609001Medicaid
HI39776OtherHMSA
HID36229Medicare UPIN
HI39776OtherHMSA