Healthcare Provider Details

I. General information

NPI: 1225356231
Provider Name (Legal Business Name): ALEXANDER A CHANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 HYDE ST STE 230
SAN FRANCISCO CA
94109-4845
US

IV. Provider business mailing address

909 HYDE ST STE 230
SAN FRANCISCO CA
94109-4845
US

V. Phone/Fax

Practice location:
  • Phone: 415-779-8332
  • Fax: 415-537-9078
Mailing address:
  • Phone: 415-779-8332
  • Fax: 415-537-9078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA127376
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA127376
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: