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General NPI Number Information
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NPI Number | 1427029677
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Entity Type | Individual
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Provider Name | RUEY-KANG R. CHANG M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 1360 VALLEY VISTA DR STE 203
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City | DIAMOND BAR
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State | CA
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Zip | 91765-3953
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Country | US
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Telephone | 310-866-0709
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Fax | 310-755-3108
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Provider Business Mailing Address
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Address Line | 1360 VALLEY VISTA DR STE 203
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City | DIAMOND BAR
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State | CA
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Zip | 91765-3953
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Country | US
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Telephone | 310-866-0709
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Fax | 310-755-3108
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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 | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | A53331
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License Number State | CA
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