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General NPI Number Information
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NPI Number | 1689724254
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Entity Type | Individual
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Provider Name | THOMAS RYAN CHANG M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 2270 S RIDGEVIEW DR STE 201
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City | YUMA
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State | AZ
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Zip | 85364-8880
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Country | US
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Telephone | 928-344-5055
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 S AVENUE A
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City | YUMA
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State | AZ
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Zip | 85364-7127
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Country | US
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Telephone | 928-344-2000
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | MD057180L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 0101231575
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | MD33131
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License Number State | DC
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Taxonomy #4
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | D57780
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 01093807A
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License Number State | IN
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Taxonomy #6
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 78028
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License Number State | AZ
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