Provider Demographics
NPI:1588832349
Name:GEORGE J. CHU
Entity Type:Organization
Organization Name:GEORGE J. CHU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-532-1311
Mailing Address - Street 1:1329 LUSITANA ST STE 102
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2401
Mailing Address - Country:US
Mailing Address - Phone:808-532-1311
Mailing Address - Fax:808-536-2224
Practice Address - Street 1:1329 LUSITANA ST STE 102
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2401
Practice Address - Country:US
Practice Address - Phone:808-532-1311
Practice Address - Fax:808-536-2224
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GEORGE J. CHU
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3268261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI04458201Medicaid
HI00F049764OtherHMSA
HIA49765OtherHMSA
1513622OtherCHAMPUS
0000BDRTDOtherMEDICARE
0000BDRTDOtherMEDICARE