Provider Demographics
NPI:1861435901
Name:CHING, LISA A (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:A
Last Name:CHING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1139 9TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-2421
Mailing Address - Country:US
Mailing Address - Phone:808-383-2432
Mailing Address - Fax:808-440-6878
Practice Address - Street 1:321 N KUAKINI ST STE 308
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2360
Practice Address - Country:US
Practice Address - Phone:808-383-2432
Practice Address - Fax:808-440-6878
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-10218207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI248247-03Medicaid
HI24824701Medicaid
HIH102660Medicare PIN
HIH00966Medicare UPIN
HIH52221Medicare PIN
HIH52221Medicare PIN