Provider Demographics
NPI:1508059361
Name:CHU, BENJAMIN C (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:C
Last Name:CHU
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 1:1380 LUSITANA ST
Mailing Address - Street 2:SUITE 702
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2421
Mailing Address - Country:US
Mailing Address - Phone:808-524-1551
Mailing Address - Fax:808-524-1553
Practice Address - Street 1:1380 LUSITANA ST
Practice Address - Street 2:SUITE 702
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2421
Practice Address - Country:US
Practice Address - Phone:808-524-1551
Practice Address - Fax:808-524-1553
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI7706174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist