Provider Demographics
NPI:1295144103
Name:NANCY CHEN, M.D., INC.
Entity type:Organization
Organization Name:NANCY CHEN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-674-2273
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-10756207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI49319801Medicaid
HIP01070482OtherMEDICARE RAILROAD
HI4439220001Medicare NSC
HIH54081Medicare PIN