Basic Information
Provider Information
NPI: 1053871632
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HSU
FirstName: GREGORY
MiddleName: CHENHU
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1301 PUNCHBOWL ST
Address2:  
City: HONOLULU
State: HI
PostalCode: 968132499
CountryCode: US
TelephoneNumber: 8086911000
FaxNumber:  
Practice Location
Address1: 1301 PUNCHBOWL ST
Address2:  
City: HONOLULU
State: HI
PostalCode: 968132499
CountryCode: US
TelephoneNumber: 8086911000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/21/2019
LastUpdateDate: 08/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000XMD-22665HIY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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