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General NPI Number Information
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NPI Number | 1275871436
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Entity Type | Organization
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Legal Business Name | HUDSON MEDICAL GROUP
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Dates
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Enumeration Date | 01/23/2013
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Last Update Date | 01/23/2013
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Provider Practice Location Address
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Address Line | 530 S LAKE AVE # 451
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City | PASADENA
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State | CA
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Zip | 91101-3515
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Country | US
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Telephone | 888-777-6636
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Fax | 626-408-6624
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Provider Business Mailing Address
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Address Line | 530 S LAKE AVE # 451
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City | PASADENA
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State | CA
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Zip | 91101-3515
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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 | VICE PRESIDENT
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Name | PETER CHANG
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Credential |
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Telephone | 888-777-6639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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