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General NPI Number Information
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NPI Number | 1235160409
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Entity Type | Individual
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Provider Name | CYNTHIA M CARSOLIN-CHANG M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 11/01/2017
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Provider Practice Location Address
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Address Line | 1800 SULLIVAN AVE RM 506
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City | DALY CITY
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State | CA
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Zip | 94015-2225
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Country | US
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Telephone | 415-642-5881
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Fax | 415-647-0841
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Provider Business Mailing Address
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Address Line | 1800 SULLIVAN AVE RM 506
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City | DALY CITY
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State | CA
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Zip | 94015-2225
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Country | US
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Telephone | 415-642-5881
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Fax | 415-647-0841
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | A48831
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License Number State | CA
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