1437151032 NPI number — DIANE L CHING MD

Table of content: DIANE L CHING MD (NPI 1437151032)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437151032 NPI number — DIANE L CHING MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHING
Provider First Name:
DIANE
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437151032
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1415 AUPUPU ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KAILUA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96734-4144
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-888-2805
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
91-525 FARRINGTON HWY
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-697-3800
Provider Business Practice Location Address Fax Number:
808-697-3818
Provider Enumeration Date:
08/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  MD-8553 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 52707 . This is a "CMSP/HSP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0165620 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 551267 . This is a "AETNA /US HEALTHCARE (43)" identifier . This identifiers is of the category "OTHER".
  • Identifier: J24602 . This is a "BCBS-MA (218)" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2774102 . This is a "OXFORD (34)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 204372 . This is a "HPHC (7)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3351755 . This is a "AETNA/US HEALTHCARE HMO46" identifier . This identifiers is of the category "OTHER".
  • Identifier: 210351 . This is a "MEDICAL LICENSE # (1)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9259605 . This is a "CIGNA (33)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 210351 . This is a "TUFTS (42)" identifier . This identifiers is of the category "OTHER".




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