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General NPI Number Information
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NPI Number | 1356696017
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Entity Type | Individual
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Provider Name | SUSAN S CHANG PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 2510 EL CAMINO REAL
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City | CARLSBAD
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State | CA
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Zip | 92008-1273
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Country | US
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Telephone | 760-729-8941
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Fax | 760-729-6741
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Provider Business Mailing Address
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Address Line | 2510 EL CAMINO REAL
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City | CARLSBAD
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State | CA
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Zip | 92008-1273
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Country | US
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Telephone | 760-729-8941
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Fax | 760-729-6741
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 64218
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License Number State | CA
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