Healthcare Provider Details

I. General information

NPI: 1053775098
Provider Name (Legal Business Name): BRANDON YUN-YAUR CHANG PHARMD, BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 06/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD
LOS ANGELES CA
90073
US

IV. Provider business mailing address

7 CIELO CT
ORINDA CA
94563-4205
US

V. Phone/Fax

Practice location:
  • Phone: 310-478-3711
  • Fax:
Mailing address:
  • Phone: 408-242-4758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number75578
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: