Provider Demographics
NPI:1578818977
Name:CHUN, KENDRICK GK (LMT)
Entity type:Individual
Prefix:MR
First Name:KENDRICK
Middle Name:GK
Last Name:CHUN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 MAKALOA ST
Mailing Address - Street 2:STE. 880
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3237
Mailing Address - Country:US
Mailing Address - Phone:808-351-4000
Mailing Address - Fax:
Practice Address - Street 1:1580 MAKALOA ST
Practice Address - Street 2:STE. 880
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3237
Practice Address - Country:US
Practice Address - Phone:808-351-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-4526174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist