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General NPI Number Information
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NPI Number | 1629151212
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Entity Type | Individual
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Provider Name | LIAN S CHANG M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 03/16/2018
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Provider Practice Location Address
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Address Line | 10751 LYNDALE BLUFFS TRL
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City | BLOOMINGTON
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State | MN
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Zip | 55420-5652
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Country | US
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Telephone | 651-628-0368
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Fax | 651-636-7273
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Provider Business Mailing Address
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Address Line | 10751 LYNDALE BLUFFS TRL
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City | BLOOMINGTON
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State | MN
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Zip | 55420-5652
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Country | US
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Telephone | 651-628-0368
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Fax | 651-636-7273
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 38766
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License Number State | MN
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