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General NPI Number Information
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NPI Number | 1063563021
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Entity Type | Individual
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Provider Name | PETER CHANG M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 12/31/2007
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Provider Practice Location Address
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Address Line | 2400 PANORAMA TER
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City | LOS ANGELES
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State | CA
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Zip | 90039-2538
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Country | US
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Telephone | 415-216-7313
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 PANORAMA TER
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City | LOS ANGELES
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State | CA
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Zip | 90039-2538
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Country | US
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Telephone | 415-578-4566
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A94532
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License Number State | CA
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