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General NPI Number Information
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NPI Number | 1336396373
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Entity Type | Individual
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Provider Name | WANDA SHOK YIN CHANG M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/21/2008
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 6670 ALTON PKWY
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City | IRVINE
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State | CA
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Zip | 92618-3734
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Country | US
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Telephone | 949-932-5398
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Fax |
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Provider Business Mailing Address
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Address Line | 4201 W CHAPMAN AVE
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City | ORANGE
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State | CA
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Zip | 92868-1505
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Country | US
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Telephone | 949-932-5398
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | A105274
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License Number State | CA
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