Provider Demographics
NPI:1750509253
Name:GRANDA, CHIA (MD)
Entity Type:Individual
Prefix:
First Name:CHIA
Middle Name:
Last Name:GRANDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5972 HEAMOI PL
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-9704
Mailing Address - Country:US
Mailing Address - Phone:808-386-4860
Mailing Address - Fax:808-274-3889
Practice Address - Street 1:3-3204 KUHIO HWY STE 104
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1135
Practice Address - Country:US
Practice Address - Phone:808-386-4860
Practice Address - Fax:808-274-3889
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI158022084P0804X
RILP000652084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry