Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | A89829 | CA |
Y | 207QS0010X | Family Doctor - Sports Medicine | MD-14407 | HI |
NPI | 1336254044 |
---|---|
Provider Name | Benjamin J. D. H. Chun |
First Address | Honolulu, HI 96819-1469 |
Second Address | Honolulu, HI 96819-1469 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 15/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000268839 | HMSA BILLING NUMBER (01) | HI |
00A898290 | (05) | CA |
I27820 | (02) |