Healthcare Provider Details

I. General information

NPI: 1265432991
Provider Name (Legal Business Name): EUGENE Y CHANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5832 BEACH BLVD UNIT 109
BUENA PARK CA
90621-5500
US

IV. Provider business mailing address

PO BOX 190
BUENA PARK CA
90621-0190
US

V. Phone/Fax

Practice location:
  • Phone: 714-228-1888
  • Fax: 714-676-1984
Mailing address:
  • Phone: 714-228-1888
  • Fax: 714-676-1984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number036111048
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD183525
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberA77825
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberMD183525
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: