Provider Demographics
NPI:1750522603
Name:CHIB, VINEET K (MD)
Entity type:Individual
Prefix:
First Name:VINEET
Middle Name:K
Last Name:CHIB
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:PO BOX 16961
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97292-0961
Mailing Address - Country:US
Mailing Address - Phone:808-676-5400
Mailing Address - Fax:
Practice Address - Street 1:94-800 UKEE ST
Practice Address - Street 2:STE 303
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4044
Practice Address - Country:US
Practice Address - Phone:808-676-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI172302085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A1080850Medicaid
HI741084Medicaid
CACJ546ZMedicare PIN
HI741084Medicaid