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Physician Compare National (NPI:1285019059)

HEALTHCARE PROVIDER: CHANG KIM DC

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1285019059
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5294073375
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20190214003056
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name KIM
Individual professional last name
Provider First Name CHANG
Individual professional first name
Provider Middle Name H
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name PALMER COLLEGE CHIROPRACTIC - DAVENPORT
Individual professional's medical school
Graduation Year 2011
Individual professional's medical school graduation year
Primary Specialty CHIROPRACTIC
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 2576 ROYAL LN
Group Practice or individual's line 1 address
City DALLAS
Group Practice or individual's city
State TX
Group Practice or individual's state
Zip Code 752293417
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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