1568481281 NPI number — DR. CHESTER SUNG CHING MD

Table of content: HANNA MARGUERITE CRESCI (NPI 1912564634)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568481281 NPI number — DR. CHESTER SUNG CHING MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHING
Provider First Name:
CHESTER
Provider Middle Name:
SUNG
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1568481281
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
620 SW 5TH AVE
Provider Second Line Business Mailing Address:
STE 900 #88
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-688-0906
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
94-229 WAIPAHU DEPOT ST STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797-3032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-206-9849
Provider Business Practice Location Address Fax Number:
808-206-9850
Provider Enumeration Date:
07/19/2006

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: 207RN0300X , with the licence number:  MD20815 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X , with the licence number: MD-20803 , 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: 004219 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




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