Provider Demographics
NPI:1699006544
Name:CHELSEA CHING-ENDOW MD LLC
Entity Type:Organization
Organization Name:CHELSEA CHING-ENDOW MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:KFY
Authorized Official - Last Name:CHING-ENDOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-729-9090
Mailing Address - Street 1:1029 KAPAHULU AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1332
Mailing Address - Country:US
Mailing Address - Phone:808-733-5111
Mailing Address - Fax:808-733-5122
Practice Address - Street 1:1029 KAPAHULU AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1332
Practice Address - Country:US
Practice Address - Phone:808-733-5111
Practice Address - Fax:808-733-5122
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHELSEA CHING-ENDOW M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-15
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD14571207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty