Provider Demographics
NPI:1700082898
Name:CHINN, PATRICIA LUCILLE (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LUCILLE
Last Name:CHINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2228 LILIHA ST
Mailing Address - Street 2:SUITE 403
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817
Mailing Address - Country:US
Mailing Address - Phone:808-523-9922
Mailing Address - Fax:808-523-9923
Practice Address - Street 1:2228 LILIHA ST
Practice Address - Street 2:SUITE 403
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-523-9922
Practice Address - Fax:808-523-9923
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3825208600000X
CA19370208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI05437201Medicaid
HI62737OtherHMSA
A94848Medicare UPIN
HI0000BDQBNMedicare ID - Type Unspecified