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General NPI Number Information
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NPI Number | 1134051360
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Entity Type | Organization
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Legal Business Name | DIANA CHANG OD LLC
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Dates
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Enumeration Date | 06/01/2026
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 10600 COORS BYPASS NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-3930
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Country | US
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Telephone | 505-922-0738
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Fax |
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Provider Business Mailing Address
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Address Line | 6400 GLENDALE AVE NE 2128
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City | ALBUQUERQUE
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State | NM
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Zip | 87113
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DIANA CHANG
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Credential |
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Telephone | 505-569-1146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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