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General NPI Number Information
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NPI Number | 1790090751
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Entity Type | Organization
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Legal Business Name | MIN SHONG CHANG MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/16/2010
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 27171 CALAROGA AVE SUITE 14
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City | HAYWARD
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State | CA
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Zip | 94545-4344
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Country | US
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Telephone | 510-782-1972
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Fax | 510-782-1973
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Provider Business Mailing Address
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Address Line | 27171 CALAROGA AVE SUITE 14
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City | HAYWARD
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State | CA
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Zip | 94545-4344
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Country | US
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Telephone | 510-782-1972
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Fax | 510-782-1973
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MIN SHONG CHANG
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Credential | M.D.
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Telephone | 510-782-1972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A37315
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License Number State | CA
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