MEDICARE: GRACE CHANG PHARM D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	47224	CA

General Provider Information

NPI Number	:	1063886513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE CHANG PHARM D

Provider Business Mailing Address
First Line	:	525 W CAPITOL EXPY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95136-3914
Country	:	US
Telephone Number	:	408-448-9224
Fax Number	:	408-448-9222

Provider Business Practice Location Address
First Line	:	525 W CAPITOL EXPY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95136-3914
Country	:	US
Telephone Number	:	408-448-9224
Fax Number	:	408-448-9222

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2015
Last Update Date	:	11/20/2015

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Directions to “ GRACE CHANG PHARM D” Practice Location

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