| |
6600 Kalanianaole Hwy Ste 114c, Honolulu, HI 96825-1273 | |
(808) 373-9373 | |
(808) 373-9370 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 6600 Kalanianaole Hwy Ste 114c, Honolulu, Hawaii |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1437697166 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | 17620 (Hawaii) | Primary |
Provider Name | Kenneth K Chang |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1134236821 PECOS PAC ID: 5193729713 Enrollment ID: I20141203000019 |
Mailing Address | Practice Location Address |
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6600 Kalanianaole Hwy Ste 114c, Honolulu, HI 96825-1273 Ph: (808) 373-9373 | 6600 Kalanianaole Hwy Ste 114c, Honolulu, HI 96825-1273 Ph: (808) 373-9373 |