| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SHELBI CHING JIM ON | 1184923765 | 2024-07-06 |
Shelbi C Jim On [F] graduated in 2011 and primarily specializes in Dermatology.
Shelbi Ching Jim On is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1184923765. Registration indicates Shelbi Ching Jim On is a provider of services with a specialization in Dermatology (Allopathic & Osteopathic Physicians, Dermatology) (Specialist Network, ) (Dermatology, Allopathic & Osteopathic Physicians) (Dermatology, ) (Allopathic & Osteopathic Physicians, Dermatology) (Specialist Network, ) (Dermatology, Allopathic & Osteopathic Physicians)
| PECOS ID | 1557646981 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Shelbi Ching Jim On MD |
| Practice Office Address | 3221 WAIALAE AVE STE 382 HONOLULU, HI US |
| Practice Office Telephone | 8089400961 |
| Practice Office Fax | 8082014951 |
| Mailing Address | 3221 WAIALAE AVE STE 382 HONOLULU, HI 968165845 US |
| Business Telephone | 8089400961 |
| Business Fax | 8082014951 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 5 E 98th St # 1048 Mt Sinai School of Medicine, Dept of Dermatology | New York, NY 100296501 | 2122413288 |
| 1276 Fulton Ave Ste 228 | Bronx, NY 10456 | 7189927669 |
| Code | Practice | License No State |
|---|---|---|
| 207N00000X | Dermatology Allopathic & Osteopathic Physicians Dermatology Specialist Network Dermatology Allopathic & Osteopathic Physicians | 265484
NY |
| 207N00000X PRIMARY | Dermatology Allopathic & Osteopathic Physicians Dermatology Specialist Network Dermatology Allopathic & Osteopathic Physicians | MD-20868
HI |
| MD-20868 | OTHER | HI | LICENSE |
| 04683730 | MEDICAID | NY |