Provider Demographics
NPI:1316265366
Name:KER-MING CHANG M D INC
Entity type:Organization
Organization Name:KER-MING CHANG M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KER-MING
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-735-9093
Mailing Address - Street 1:575 COOKE ST STE A
Mailing Address - Street 2:PMB 2524
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5274
Mailing Address - Country:US
Mailing Address - Phone:808-735-9093
Mailing Address - Fax:
Practice Address - Street 1:575 COOKE ST STE A
Practice Address - Street 2:PMB 2524
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5274
Practice Address - Country:US
Practice Address - Phone:808-735-9093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-4310207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty