| C. Kimo Chan, M.d., Llc | |
|
46-271 Haiku Rd Kaneohe HI 96744-4144 | |
| (808) 235-4204 | |
| Not Available |
| Full Name | C. Kimo Chan, M.d., Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 46-271 Haiku Rd, Kaneohe, Hawaii |
| Authorized Official Name and Position | C. Kimo Chan (CHILD & ADOLESCENT PSYCHIATRIST) |
| Authorized Official Contact | 8083711311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| C. Kimo Chan, M.d., Llc 46-271 Haiku Rd Kaneohe HI 96744-4144 Ph: (808) 235-4204 | C. Kimo Chan, M.d., Llc 46-271 Haiku Rd Kaneohe HI 96744-4144 Ph: (808) 235-4204 |
| NPI Number | 1063740470 |
|---|---|
| Provider Enumeration Date | 11/23/2009 |
| Last Update Date | 11/23/2009 |
| Medicare PECOS PAC ID | 7012215957 |
|---|---|
| Medicare Enrollment ID | O20160411000736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063740470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Clayton Kimo Chan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144309576 PECOS PAC ID: 8921306861 Enrollment ID: I20160411000772 |
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