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General NPI Number Information
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NPI Number | 1023136496
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Entity Type | Organization
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Legal Business Name | ALBERT S. CHANG D.D.S., INC,
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2557 CHINO HILLS PKWY STE. C
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City | CHINO HILLS
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State | CA
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Zip | 91709-5103
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Country | US
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Telephone | 909-393-7500
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Fax | 909-393-6222
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Provider Business Mailing Address
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Address Line | 2557 CHINO HILLS PKWY STE. C
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City | CHINO HILLS
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State | CA
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Zip | 91709-5103
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Country | US
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Telephone | 909-393-7500
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Fax | 909-393-6222
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | VICTORIA SALINAS
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Credential | RDA
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Telephone | 909-393-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 35858
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License Number State | CA
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