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General NPI Number Information
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NPI Number | 1659807170
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Entity Type | Organization
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Legal Business Name | PETER CHANG-SING, MD
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 500 DOYLE PARK DR SUITE 302
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City | SANTA ROSA
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State | CA
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Zip | 95405-4558
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Country | US
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Telephone | 707-573-7070
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Fax | 707-573-7519
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Provider Business Mailing Address
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Address Line | PO BOX 3368
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City | SANTA ROSA
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State | CA
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Zip | 95402-3368
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Country | US
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Telephone | 707-573-7070
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Fax | 707-573-7519
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Authorized Official
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Title or Position | OWNER
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Name | PETER DG CHANG-SING
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Credential | M.D.
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Telephone | 707-573-7070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | G59460
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License Number State | CA
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