Provider Demographics
NPI:1467558023
Name:CHANG TAKAHASHI, MAUREEN OJC (MD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:OJC
Last Name:CHANG TAKAHASHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1319 PUNAHOU ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1001
Mailing Address - Country:US
Mailing Address - Phone:808-983-8641
Mailing Address - Fax:808-983-6937
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-983-8641
Practice Address - Fax:808-983-6937
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-8421208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIG26079Medicare UPIN