Provider Demographics
NPI:1982866539
Name:GRACE, CHELESTES LEE KANOELEHUA (MD)
Entity Type:Individual
Prefix:
First Name:CHELESTES LEE
Middle Name:KANOELEHUA
Last Name:GRACE
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 1:2637 KUILEI ST APT A74
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-3217
Mailing Address - Country:US
Mailing Address - Phone:808-358-9796
Mailing Address - Fax:
Practice Address - Street 1:651 ILALO ST
Practice Address - Street 2:MEB #401A
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5525
Practice Address - Country:US
Practice Address - Phone:808-358-9796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMDR-5454207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology