Provider Demographics
NPI:1528284684
Name:WEI CHAO, M.D., LLC
Entity type:Organization
Organization Name:WEI CHAO, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WEI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-735-9093
Mailing Address - Street 1:1253 S BERETANIA ST
Mailing Address - Street 2:SUITE 2325
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1822
Mailing Address - Country:US
Mailing Address - Phone:808-735-9093
Mailing Address - Fax:808-732-6647
Practice Address - Street 1:1253 S BERETANIA ST
Practice Address - Street 2:SUITE 2325
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1822
Practice Address - Country:US
Practice Address - Phone:808-735-9093
Practice Address - Fax:808-732-6647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD7896174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0007576414Medicaid
HIMD7896OtherMD LICENSE
HIH102333Medicare PIN
HIG09260Medicare UPIN