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General NPI Number Information
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NPI Number | 1164985263
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Entity Type | Individual
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Provider Name | RYAN CHANG
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Gender | Male
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Dates
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Enumeration Date | 04/08/2019
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 218 DE ANZA BLVD
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City | SAN MATEO
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State | CA
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Zip | 94402-3913
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Country | US
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Telephone | 415-514-7520
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Fax |
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Provider Business Mailing Address
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Address Line | 1 HAWTHORNE ST UNIT 20F
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City | SAN FRANCISCO
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State | CA
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Zip | 94105-3983
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Country | US
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Telephone | 415-937-3662
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | A179941
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License Number State | CA
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