Raquel Jenn Leun Chan-Ikeda, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD - 9598 Issued in HI

Practice address

302 California Ave Ste 209
Wahiawa, HI 96786-1841

Phone

(808) 622-2655

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1316004740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 CALIFORNIA AVE STE 209",
            "city": "WAHIAWA",
            "state": "HI",
            "postal_code": "967861841",
            "telephone_number": "808-622-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 CALIFORNIA AVE STE 209",
            "city": "WAHIAWA",
            "state": "HI",
            "postal_code": "967861841",
            "telephone_number": "808-622-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN-IKEDA",
        "first_name": "RAQUEL",
        "middle_name": "JENN LEUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD - 9598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystel Capi Montijo
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• Nicole Marie Napuanani Carter, DPT
• Center Pharmacy, Inc.
• Kelly Michele Cerutti, ANP
• Kristi Anne Hidemi Chang Pacpaco, PHARMD
• Jorge Chanon, EMT-B
• Betty Seu Ming Chao, MFT
• Chiroplan Hawaii, Inc.
• Sara Christensen, MD

• Pediatrics Physician in Wahiawa, HI
• Providers in Wahiawa, HI by specialty
• Pediatrics Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.