Provider Demographics
NPI:1265427900
Name:CHEN, NANCY (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:CHEN
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 1:511 MANAWAI ST. #401
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2027
Mailing Address - Country:US
Mailing Address - Phone:808-674-2273
Mailing Address - Fax:
Practice Address - Street 1:511 MANAWAI ST. #401
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2027
Practice Address - Country:US
Practice Address - Phone:808-674-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10756207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI990355307OtherUHA PROVIDER
HI197099OtherHMA PROVIDER
4931984OtherALOHA CARE PROVIDER
HI49319801Medicaid
HIMD10756-01OtherQUEEN'S PROVIDER
HI00A0219509OtherHMSA PROVIDER
HI00A0219509OtherHMSA PROVIDER
HI49319801Medicaid