Healthcare Provider Details

I. General information

NPI: 1275057333
Provider Name (Legal Business Name): VICTORIA CHANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2017
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 E BASELINE RD
PHOENIX AZ
85042-6554
US

IV. Provider business mailing address

6235 N 19TH ST
PHOENIX AZ
85016-1605
US

V. Phone/Fax

Practice location:
  • Phone: 602-243-3014
  • Fax: 602-305-9092
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS022763
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS022763
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: