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General NPI Number Information
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NPI Number | 1619062973
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Entity Type | Organization
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Legal Business Name | BAYARD W. CHANG, MD, INC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 01/25/2008
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Provider Practice Location Address
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Address Line | 500 UNIVERSITY AVE STE 111
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City | SACRAMENTO
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State | CA
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Zip | 95825-6504
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Country | US
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Telephone | 916-929-2526
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Fax | 916-929-6128
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Provider Business Mailing Address
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Address Line | 500 UNIVERSITY AVE SUITE 111
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City | SACRAMENTO
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State | CA
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Zip | 95825-6504
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Country | US
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Telephone | 916-929-2526
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Fax | 916-929-6128
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BAYARD WON CHANG
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Credential | MD
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Telephone | 916-929-2526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | G064347
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License Number State | CA
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