Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 3276 | HI |
N | 208000000X | Pediatrician | A34951 | CA |
N | 208000000X | Pediatrician | MD00018470 | WA |
N | 2080P0214X | Pediatric Pulmonologist | 3276 | HI |
NPI | 1033147335 |
---|---|
Provider Name | Fuchat Chan |
First Address | Ewa Beach, HI 96706-3608 |
Second Address | Ewa Beach, HI 96706-3608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F50979 | (02) |