Active NPI
Peter Lung-Sang Chan, M.D.
- Geriatric Medicine (Internal Medicine) Physician
- Kaunakakai, HI
National Provider Identifier
1174905152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 10175
- Practice address
- 9 Hooulu Place
Kaunakakai, HI 96748-1649 - Phone
- (808) 553-3086
- NPI assigned
- Jun 25, 2015
- Last updated
- Jun 25, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 10175 | HI | Primary |
Addresses
Primary practice location
9 Hooulu Place
Kaunakakai, HI 96748-1649
Mailing address
PO Box 1649
9 Hooulu Place
Kaunakakai, HI 96748-1649
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10175 | HI | MD | Geriatric Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435190400000",
"number": "1174905152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1649",
"address_2": "9 HOOULU PLACE",
"city": "KAUNAKAKAI",
"state": "HI",
"postal_code": "967481649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 HOOULU PLACE",
"city": "KAUNAKAKAI",
"state": "HI",
"postal_code": "967481649",
"telephone_number": "808-553-3086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "PETER",
"middle_name": "LUNG-SANG",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-25",
"last_updated": "2015-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "HI",
"license": "10175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kaunakakai, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.