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NPI 1700516358

NPI 1700516358 : JASYN YANBO CHANG DO : PAOLI, PA

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General NPI Number Information
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    NPI Number           |    1700516358
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    Entity Type          |    Individual 
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    Provider Name        |    JASYN YANBO CHANG DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/15/2022
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    Last Update Date     |    07/29/2025
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Provider Practice Location Address
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    Address Line         |    255 W LANCASTER AVE 
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    City                 |    PAOLI
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    State                |    PA
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    Zip                  |    19301-1763
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    Country              |    US
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    Telephone            |    484-565-1000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3803 W CHESTER PIKE STE 160 
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    City                 |    NEWTOWN SQUARE
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    State                |    PA
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    Zip                  |    19073-2336
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    Country              |    US
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    Telephone            |    484-337-1632
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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        |    208M00000X
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    Taxonomy Name        |    Hospitalist Physician
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    License Number       |    OS025082
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    License Number State |    PA
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Taxonomy #2
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    OS025082
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    License Number State |    PA
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