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General NPI Number Information
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NPI Number | 1174827885
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Entity Type | Individual
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Provider Name | KARA WONG CHANG DDS
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Gender | Female
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 01/28/2014
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Provider Practice Location Address
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Address Line | 3400 CALIFORNIA ST STE 301
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1863
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Country | US
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Telephone | 415-567-2408
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Fax |
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Provider Business Mailing Address
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Address Line | 119 DARTMOUTH RD
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City | SAN MATEO
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State | CA
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Zip | 94402-1620
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Country | US
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Telephone | 832-409-8052
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 26108
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.028600
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 63096
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License Number State | CA
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