Provider Demographics
NPI:1437151032
Name:CHING, DIANE L (MD)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:L
Last Name:CHING
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 1:1415 AUPUPU ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4144
Mailing Address - Country:US
Mailing Address - Phone:808-888-2805
Mailing Address - Fax:
Practice Address - Street 1:91-525 FARRINGTON HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707
Practice Address - Country:US
Practice Address - Phone:808-697-3800
Practice Address - Fax:808-697-3818
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-8553208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
52707OtherCMSP/HSP
MA0165620Medicaid
551267OtherAETNA /US HEALTHCARE (43)
J24602OtherBCBS-MA (218)
P2774102OtherOXFORD (34)
204372OtherHPHC (7)
3351755OtherAETNA/US HEALTHCARE HMO46
210351OtherMEDICAL LICENSE # (1)
9259605OtherCIGNA (33)
210351OtherTUFTS (42)
52707OtherCMSP/HSP