Provider Demographics
NPI:1841210341
Name:DAVID STEIN M D PH D INC
Entity Type:Organization
Organization Name:DAVID STEIN M D PH D INC
Other - Org Name:CHRYSALIS INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:808-591-9116
Mailing Address - Street 1:1350 S KING ST STE 325
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2008
Mailing Address - Country:US
Mailing Address - Phone:808-591-9116
Mailing Address - Fax:808-591-9655
Practice Address - Street 1:1350 S KING ST STE 325
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2008
Practice Address - Country:US
Practice Address - Phone:808-591-9116
Practice Address - Fax:808-591-9655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD57282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI02161401Medicaid
HI00R0023920OtherBLUE CROSS/ BLUE SHIELD
HI02161401OtherALOHA CARE
HIMD5728-05OtherQHCP/MDX
HI=========OtherCHAMPUS
HIMD5728-05OtherQHCP/MDX
HI02161401OtherALOHA CARE
HI02161401OtherALOHA CARE
HI=========OtherCHAMPUS