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General NPI Number Information
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NPI Number | 1629091186
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Entity Type | Individual
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Provider Name | CLIFF F CHANG D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9842 BOLSA AVE SUITE 201B
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City | WESTMINSTER
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State | CA
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Zip | 92683-6680
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Country | US
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Telephone | 714-418-0219
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Fax | 714-418-0124
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Provider Business Mailing Address
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Address Line | 10 CIPRIANI
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City | IRVINE
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State | CA
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Zip | 92606-8869
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Country | US
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Telephone | 714-418-0219
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Fax | 714-418-0124
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 37397
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License Number State | CA
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