Provider Demographics
NPI:1871790824
Name:TAGAWA, CHELSEA WALKER (MD)
Entity type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:WALKER
Last Name:TAGAWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 JARRETT WHITE RD
Mailing Address - Street 2:
Mailing Address - City:TRIPLER ARMY MEDICAL CENTER
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5001
Mailing Address - Country:US
Mailing Address - Phone:808-433-2202
Mailing Address - Fax:808-433-1153
Practice Address - Street 1:1 JARRETT WHITE RD
Practice Address - Street 2:
Practice Address - City:TRIPLER ARMY MEDICAL CENTER
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-2202
Practice Address - Fax:808-433-1153
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine