Provider Demographics
NPI:1437292729
Name:YEH, SU JUEN CHRIS (MD)
Entity Type:Individual
Prefix:MR
First Name:SU JUEN
Middle Name:CHRIS
Last Name:YEH
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 1:2222 KALAKAUA AVE.
Mailing Address - Street 2:SUITE 603
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815
Mailing Address - Country:US
Mailing Address - Phone:808-921-0330
Mailing Address - Fax:
Practice Address - Street 1:2222 KALAKAUA AVE.
Practice Address - Street 2:SUITE 603
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815
Practice Address - Country:US
Practice Address - Phone:808-921-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 8657207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000BDZKDMedicare ID - Type Unspecified
HIF96748Medicare UPIN