Healthcare Provider Details

I. General information

NPI: 1154700789
Provider Name (Legal Business Name): CHE MIN CHANG PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 29TH ST STE 690
SACRAMENTO CA
95816-5126
US

IV. Provider business mailing address

1020 29TH ST STE 690
SACRAMENTO CA
95816-5126
US

V. Phone/Fax

Practice location:
  • Phone: 916-887-4680
  • Fax:
Mailing address:
  • Phone: 916-887-4680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number82610
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: