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NPI Code Detail

MEDICARE: HENRY HUNG YAT CHANG PHARM.D.

MEDICARE: HENRY HUNG YAT 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
1183500000XPharmacist53723CA

General Provider Information

NPI Number : 1104560986
Entity Type Code : Individual
Provider Name (Legal Business Name) : HENRY HUNG YAT CHANG PHARM.D.
Provider Business Mailing Address
First Line : 1555 KENSINGTON RD
Second Line :
City : SAN MARINO
State : CA
Zip : 91108-1927
Country : US
Telephone Number : 626-590-6666
Fax Number :
Provider Business Practice Location Address
First Line : 2035 S MYRTLE AVE
Second Line :
City : MONROVIA
State : CA
Zip : 91016-4836
Country : US
Telephone Number : 626-590-6666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2022
Last Update Date : 04/26/2022

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