Provider Demographics
NPI:1609888106
Name:CHUN, DEANE T (MD)
Entity type:Individual
Prefix:
First Name:DEANE
Middle Name:T
Last Name:CHUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 SOUTH BERETANIA STREET
Mailing Address - Street 2:#201-202
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1149
Mailing Address - Country:US
Mailing Address - Phone:808-946-1712
Mailing Address - Fax:808-946-1728
Practice Address - Street 1:1575 SOUTH BERETANIA STREET
Practice Address - Street 2:#201-202
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1149
Practice Address - Country:US
Practice Address - Phone:808-946-1712
Practice Address - Fax:808-946-1728
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10867207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI49314801Medicaid
HI0218297OtherHMSA
H07936Medicare UPIN
HI52223Medicare ID - Type Unspecified