Provider Demographics
NPI:1134619729
Name:IMANAKA, CHAD (MD)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:IMANAKA
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:BRAIN HEALTH HAWAII
Mailing Address - Street 2:4211 WAIALAE AVE SUITE 203
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1030
Mailing Address - Country:US
Mailing Address - Phone:808-554-5688
Mailing Address - Fax:
Practice Address - Street 1:PSYCHIATRY RESIDENCY PROGRAM
Practice Address - Street 2:1356 LUSITANA STREET, 4TH FLOOR
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-1030
Practice Address - Country:US
Practice Address - Phone:808-895-7948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-223932084P0800X
HIMDR-75282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry