Provider Demographics
NPI:1609542141
Name:COREY C CHINN MD LLC
Entity Type:Organization
Organization Name:COREY C CHINN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHINN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-286-9730
Mailing Address - Street 1:848 S BERETANIA ST STE 400
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2551
Mailing Address - Country:US
Mailing Address - Phone:808-536-0314
Mailing Address - Fax:808-536-0320
Practice Address - Street 1:909 KAPIOLANI BLVD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2199
Practice Address - Country:US
Practice Address - Phone:808-286-9730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty