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NPI Code Detail

MEDICARE: DR. AIMEE S CHANG MD

MEDICARE:  DR. AIMEE S CHANG  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207VE0102XReproductive Endocrinology Physician2002005827MO
2207VE0102XReproductive Endocrinology PhysicianMD27368OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1157258OTHERMO-BLUE SHIELD

General Provider Information

NPI Number : 1073531554
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AIMEE S CHANG MD
Provider Business Mailing Address
First Line : 9370 SW GREENBURG RD
Second Line : SUITE 412
City : PORTLAND
State : OR
Zip : 97223-5442
Country : US
Telephone Number : 503-292-7734
Fax Number : 503-292-7735
Provider Business Practice Location Address
First Line : 9370 SW GREENBURG RD
Second Line : SUITE 412
City : PORTLAND
State : OR
Zip : 97223-5442
Country : US
Telephone Number : 503-292-7734
Fax Number : 503-292-7735
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 06/18/2009

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Directions to “ DR. AIMEE S CHANG MD” Practice Location

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