Justin Chang

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Waimanalo, HI

NPI 1215636717 · NPPES record last updated Feb 23, 2023

Key facts

NPI
1215636717
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
41-1347 Kalanianaole Hwy
Waimanalo, HI 96795-1247
Phone
(808) 259-5466
NPI assigned
Feb 23, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

41-1347 Kalanianaole Hwy
Waimanalo, HI 96795-1247

Mailing address

4034 Monticello Dr
Sugar Land, TX 77479-3825

Other providers in Waimanalo, HI

All providers in Waimanalo, HI · Student in an Organized Health Care Education/Training Program in Hawaii

Sources for this page

Verify at the official NPI Registry.