Healthcare Provider Details

I. General information

NPI: 1447356621
Provider Name (Legal Business Name): EING-MIN CHANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 06/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 PACIFIC A VE. STE 290
LONG BEACH CA
90806-2631
US

IV. Provider business mailing address

2690 PACIFIC A VE. STE 290
LONG BEACH CA
90806-2631
US

V. Phone/Fax

Practice location:
  • Phone: 562-426-8185
  • Fax: 562-988-8556
Mailing address:
  • Phone: 562-426-8185
  • Fax: 562-988-8556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA39572
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: