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NPI Code Detail

MEDICARE: VIVIAN CHANG

MEDICARE: VIVIAN CHANG
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
12080N0001XNeonatal-Perinatal Medicine PhysicianA200305CA

General Provider Information

NPI Number : 1083177265
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIVIAN CHANG
Provider Business Mailing Address
First Line : 8708 JUSTICE AVE APT 11C
Second Line :
City : ELMHURST
State : NY
Zip : 11373-4580
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1201 W LA VETA AVE
Second Line :
City : ORANGE
State : CA
Zip : 92868-4203
Country : US
Telephone Number : 714-203-2181
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2019
Last Update Date : 01/22/2026

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Directions to “ VIVIAN CHANG ” Practice Location

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