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General NPI Number Information
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NPI Number | 1902675945
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Entity Type | Organization
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Legal Business Name | RESTORE WEIGHT LOSS, PC
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Dates
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Enumeration Date | 01/01/2024
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Last Update Date | 01/01/2024
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Provider Practice Location Address
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Address Line | 2585 PACIFIC COAST HWY
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City | TORRANCE
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State | CA
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Zip | 90505-7035
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Country | US
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Telephone | 424-488-3454
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Fax | 310-800-2833
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Provider Business Mailing Address
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Address Line | 2585 PACIFIC COAST HWY
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City | TORRANCE
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State | CA
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Zip | 90505-7035
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Country | US
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Telephone | 424-488-3454
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Fax | 310-800-2833
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALLEN K CHANG
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Credential | DO
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Telephone | 424-488-3454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RB0002X
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Taxonomy Name | Obesity Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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