Provider Demographics
NPI:1992738322
Name:CHAN, OI HING (PHD)
Entity type:Individual
Prefix:
First Name:OI HING
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:OI HING
Other - Middle Name:
Other - Last Name:CHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:101 AUPUNI STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4221
Mailing Address - Country:US
Mailing Address - Phone:808-934-7880
Mailing Address - Fax:
Practice Address - Street 1:101 AUPUNI STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4221
Practice Address - Country:US
Practice Address - Phone:808-934-7880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI289103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI01559701Medicaid