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NPI Code Detail

MEDICARE: DORRIE E FUNG CHANG MD

MEDICARE: DORRIE E FUNG CHANG MD
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
1207R00000XInternal Medicine PhysicianA82050CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114952470
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORRIE E FUNG CHANG MD
Provider Business Mailing Address
First Line : 8501 WILSHIRE BLVD STE 150
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90211-3148
Country : US
Telephone Number : 310-248-7090
Fax Number : 310-248-7033
Provider Business Practice Location Address
First Line : 8501 WILSHIRE BLVD STE 150
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90211-3148
Country : US
Telephone Number : 310-248-7090
Fax Number : 310-248-7033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 07/30/2012

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