Provider Demographics
NPI:1891988408
Name:CHANG, JASON CHOKICHI (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:CHOKICHI
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2230 LILIHA ST
Mailing Address - Street 2:STE 104
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1646
Mailing Address - Country:US
Mailing Address - Phone:808-261-4476
Mailing Address - Fax:808-263-4476
Practice Address - Street 1:226 N KUAKINI STREET
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-544-3325
Practice Address - Fax:808-535-2001
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI14616208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation