Provider Demographics
NPI:1487709341
Name:CHAN, DARWIN (MD)
Entity type:Individual
Prefix:DR
First Name:DARWIN
Middle Name:
Last Name:CHAN
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 1:545 OHOHIA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1935
Mailing Address - Country:US
Mailing Address - Phone:808-831-3000
Mailing Address - Fax:808-834-5763
Practice Address - Street 1:545 OHOHIA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1935
Practice Address - Country:US
Practice Address - Phone:808-831-3000
Practice Address - Fax:808-834-5763
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI70112083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI04958701Medicaid
HI99-0273205OtherHMA-HMAA-SUMMERLIN-UHA-O
HI00A0080927OtherBLUES
HI0006095000Medicaid
HIE34709OtherUGS
HIA0006095000Medicare ID - Type UnspecifiedALOHACARE ADVANTAGE
HI55314Medicare ID - Type UnspecifiedPART B
HI99-0273205OtherHMA-HMAA-SUMMERLIN-UHA-O