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General NPI Number Information
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NPI Number | 1083149645
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Entity Type | Individual
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Provider Name | TIFFANY CHANG M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/20/2017
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 4201 SAINT ANTOINE ST UHC-2E
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City | DETROIT
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State | MI
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Zip | 48201-2153
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Country | US
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Telephone | 313-577-4342
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Fax |
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Provider Business Mailing Address
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Address Line | 505 PARNASSUS AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2204
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Country | US
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Telephone | 313-745-4627
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4351032753
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A172559
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4351032753
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License Number State | MI
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