| Carolyn Chen Clark, MD | |
|
640 Ulukahiki St, Kailua, HI 96734-4454 | |
| (503) 251-6855 | |
| Not Available |
| Full Name | Carolyn Chen Clark |
|---|---|
| Gender | Female |
| Speciality | Diagnostic Radiology |
| Experience | 10 Years |
| Location | 640 Ulukahiki St, Kailua, Hawaii |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336536036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 21521 (Hawaii) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Virginia Mason Medical Center | Seattle, WA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Virginia Mason Medical Center | 9830002617 | 839 |
| Entity Name | Diagnostic Radiologists Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053368563 PECOS PAC ID: 4183510902 Enrollment ID: O20170705003169 |
| Entity Name | Virginia Mason Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124176904 PECOS PAC ID: 9830002617 Enrollment ID: O20211201001790 |
| Mailing Address | Practice Location Address |
|---|---|
| Carolyn Chen Clark, MD Po Box 16961, Portland, OR 97292-0961 Ph: (503) 251-6855 | Carolyn Chen Clark, MD 640 Ulukahiki St, Kailua, HI 96734-4454 Ph: (503) 251-6855 |
Dr. Asti Pilika, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 611 Milokai Pl, Kailua, HI 96734 Phone: 084-162-9322 Fax: 855-673-9190 | |
Calvin B. Delaplain, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1301 Aulepe St, Kailua, HI 96734 Phone: 808-263-1958 | |
Dr. Norman T Ikemoto, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 640 Ulukahiki St, Kailua, HI 96734 Phone: 808-263-5166 Fax: 808-263-5167 | |
Dr. Venerando Seguritan, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 640 Ulukahiki St, Kailua, HI 96734 Phone: 808-263-5166 Fax: 808-263-5167 |