Provider Demographics
NPI:1316953227
Name:CHESTER, CHARLES J (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:J
Last Name:CHESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-1119 ILIEE ST
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3420
Mailing Address - Country:US
Mailing Address - Phone:504-231-7465
Mailing Address - Fax:
Practice Address - Street 1:860 4TH ST STE 204
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3690
Practice Address - Country:US
Practice Address - Phone:808-453-5953
Practice Address - Fax:808-453-5966
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-55662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1303291Medicaid
C98732Medicare UPIN
LA5K021Medicare ID - Type Unspecified