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General NPI Number Information
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NPI Number | 1487627261
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Entity Type | Individual
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Provider Name | PAUL SOOJIN CHANG M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 5832 BEACH BLVD UNIT 214
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City | BUENA PARK
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State | CA
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Zip | 90621-5501
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Country | US
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Telephone | 714-523-7575
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Fax | 714-523-7585
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Provider Business Mailing Address
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Address Line | 2654 W LA PALMA AVE
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City | ANAHEIM
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State | CA
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Zip | 92801-2601
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Country | US
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Telephone | 714-827-0700
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Fax | 714-827-2367
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G077288
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License Number State | CA
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