| Blane K. Chong, Md Sports Medicine And Family Practice Llc | |
|
3221 Waialae Ave Ste 390 Honolulu HI 96816-5850 | |
| (808) 732-9710 | |
| (808) 732-9720 |
| Full Name | Blane K. Chong, Md Sports Medicine And Family Practice Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3221 Waialae Ave Ste 390, Honolulu, Hawaii |
| Authorized Official Name and Position | Jasmine Kauka (OFFICE MANAGER) |
| Authorized Official Contact | 8087329710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blane K. Chong, Md Sports Medicine And Family Practice Llc 3221 Waialae Ave Ste 390 Honolulu HI 96816-5850 Ph: (808) 732-9710 | Blane K. Chong, Md Sports Medicine And Family Practice Llc 3221 Waialae Ave Ste 390 Honolulu HI 96816-5850 Ph: (808) 732-9710 |
| NPI Number | 1700498680 |
|---|---|
| Provider Enumeration Date | 08/20/2020 |
| Last Update Date | 07/01/2024 |
| Medicare PECOS PAC ID | 0840609699 |
|---|---|
| Medicare Enrollment ID | O20210506001516 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700498680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Blane K Chong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669584967 PECOS PAC ID: 3072582444 Enrollment ID: I20041001000461 |
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