Provider Demographics
NPI:1023059649
Name:CHINEN, CARLA L C (PT)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:L C
Last Name:CHINEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:L
Other - Last Name:CASUGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:99-128 AIEA HEIGHTS DR
Mailing Address - Street 2:STE 207
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3925
Mailing Address - Country:US
Mailing Address - Phone:808-487-0487
Mailing Address - Fax:
Practice Address - Street 1:99-128 AIEA HEIGHTS DR
Practice Address - Street 2:STE 207
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3925
Practice Address - Country:US
Practice Address - Phone:808-487-0487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-1172225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000261859OtherHMSA BILLING NUMBER