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General NPI Number Information
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NPI Number | 1558536482
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Entity Type | Organization
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Legal Business Name | CLIFFORD KARL CHANG OD INC.
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 929 CLAY ST 203
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-1556
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Country | US
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Telephone | 415-982-1700
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Fax | 415-982-1750
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Provider Business Mailing Address
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Address Line | 929 CLAY ST 203
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-1556
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Country | US
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Telephone | 415-982-1700
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Fax | 415-982-1750
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. BRADFORD KARL CHANG
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Credential | O.D.
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Telephone | 415-982-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4071
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License Number State | CA
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