Healthcare Provider Details

I. General information

NPI: 1568774560
Provider Name (Legal Business Name): EUGENIA CHANG MSN, RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2010
Last Update Date: 07/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14350 WHITTIER BLVD STE 100
WHITTIER CA
90605-2122
US

IV. Provider business mailing address

14350 WHITTIER BLVD STE 100
WHITTIER CA
90605-2122
US

V. Phone/Fax

Practice location:
  • Phone: 562-696-1104
  • Fax: 562-696-2885
Mailing address:
  • Phone: 562-696-1104
  • Fax: 562-696-2885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18771
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: