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General NPI Number Information
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NPI Number | 1730265224
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Entity Type | Organization
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Legal Business Name | KATHERINE CHANG, M.D.
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 2121 WILSHIRE BLVD STE. 201
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City | SANTA MONICA
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State | CA
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Zip | 90403-5720
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Country | US
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Telephone | 310-319-8592
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Fax |
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Provider Business Mailing Address
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Address Line | 11999 SAN VICENTE BLVD STE. 440
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City | LOS ANGELES
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State | CA
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Zip | 90049-5131
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Country | US
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Telephone | 310-440-3131
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATHERINE A. CHANG
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Credential | M.D.
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Telephone | 310-440-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G53114
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License Number State |
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