Healthcare Provider Details

I. General information

NPI: 1013233535
Provider Name (Legal Business Name): ANITA CHANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2010
Last Update Date: 10/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 WEBSTER ST ASIAN HEALTH SERVICES
OAKLAND CA
94607
US

IV. Provider business mailing address

818 WEBSTER ST ASIAN HEALTH SERVICES
OAKLAND CA
94607
US

V. Phone/Fax

Practice location:
  • Phone: 510-986-6800
  • Fax:
Mailing address:
  • Phone: 510-986-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA125147
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: