Healthcare Provider Details

I. General information

NPI: 1184218042
Provider Name (Legal Business Name): SHARON SAULAN CHANG MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2021
Last Update Date: 02/22/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

394 GLENNAN ROAD
SCHOFIELD BARRACKS HI
96857
US

IV. Provider business mailing address

76 KILANI AVE
WAHIAWA HI
96786-1559
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-8199
  • Fax: 808-433-8334
Mailing address:
  • Phone: 808-225-1946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number60479
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: