MEDICARE: BING-LO CHANG M.D.

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
1	207Q00000X	Family Medicine Physician	A45087	CA

General Provider Information

NPI Number	:	1295721900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BING-LO CHANG M.D.

Provider Business Mailing Address
First Line	:	279 IMPERIAL HWY
Second Line	:	SUITE 730
City	:	FULLERTON
State	:	CA
Zip	:	92835-1041
Country	:	US
Telephone Number	:	714-449-4841
Fax Number	:	714-449-4956

Provider Business Practice Location Address
First Line	:	2151 N HARBOR BLVD
Second Line	:	SUITE 3200
City	:	FULLERTON
State	:	CA
Zip	:	92835-3801
Country	:	US
Telephone Number	:	714-446-5101
Fax Number	:	714-871-3006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	04/30/2013

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Directions to “ BING-LO CHANG M.D.” Practice Location

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