Physician Compare National (NPI:1649349606)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1649349606
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2769668904
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110524000060
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHANG
	Individual professional last name
Provider First Name	SHUN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1973
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	EMERGENCY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	210 CANAL ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 606
	Group Practice or individual's line 2 address
City	NEW YORK
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	100134162
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2127327182
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M