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General NPI Number Information
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NPI Number | 1316166101
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Entity Type | Individual
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Provider Name | ALEX CHIEH CHANG CHAN DDS
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5303 LINCOLN AVE
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City | CYPRESS
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State | CA
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Zip | 90630-2235
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Country | US
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Telephone | 714-826-6688
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Fax | 714-826-9683
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Provider Business Mailing Address
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Address Line | 5303 LINCOLN AVE
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City | CYPRESS
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State | CA
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Zip | 90630-2235
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Country | US
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Telephone | 714-826-6688
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Fax | 714-826-9683
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 38657
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License Number State | CA
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