1750477345 NPI number — ELIZABETH A CHENG-LEEVER DPT

Table of content: ELIZABETH A CHENG-LEEVER DPT (NPI 1750477345)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750477345 NPI number — ELIZABETH A CHENG-LEEVER DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHENG-LEEVER
Provider First Name:
ELIZABETH
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
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:
1750477345
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4311 PAHOA AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-739-5769
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5722 KALANIANAOLE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96821-2388
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-373-3555
Provider Business Practice Location Address Fax Number:
808-373-3666
Provider Enumeration Date:
10/04/2006

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: 225100000X , with the licence number:  PT883 , 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: 220484 . This is a "HMA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 0000241331 . This is a "HMSA PPO/HMO/QUEST/65C" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 0000241331 . This is a "TRICARE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 54184801 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0373318 . This is a "UHA 99-0332020" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 99-0332020 . This is a "HMAA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 204196700 . This is a "OWCP" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 54184801 . This is a "ALOHA CARE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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