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General NPI Number Information
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NPI Number | 1689473811
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Entity Type | Individual
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Provider Name | ALLISSA VIVIENNE ZHEN DUR CHANG OD
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Gender | Female
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 351 E TEMPLE ST
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City | LOS ANGELES
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State | CA
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Zip | 90012-3328
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Country | US
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Telephone | 213-253-2677
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Fax | 213-253-5123
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Provider Business Mailing Address
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Address Line | 811 ROANOKE RD
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City | SAN MARINO
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State | CA
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Zip | 91108-2437
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Country | US
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Telephone | 626-679-5899
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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