Provider Demographics
NPI:1801292099
Name:HONOLULU ENDOCRINOLOGY INC
Entity type:Organization
Organization Name:HONOLULU ENDOCRINOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:YAP
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-529-2199
Mailing Address - Street 1:1380 LUSITANA ST STE 902
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2448
Mailing Address - Country:US
Mailing Address - Phone:808-524-2472
Mailing Address - Fax:808-537-5698
Practice Address - Street 1:1380 LUSITANA ST STE 902
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2448
Practice Address - Country:US
Practice Address - Phone:808-524-2472
Practice Address - Fax:808-537-5698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-14
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI17896207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAIO8183Medicare UPIN
1972584365Medicare PIN
CA00A852090Medicaid