MEDICARE: DANIEL W 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
1	207V00000X	Obstetrics & Gynecology Physician	94212	NM
2	207V00000X	Obstetrics & Gynecology Physician	25429	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12742	OTHER		PRESBYTERIAN HEALTH PLAN
2	NM014521	OTHER	NM	BCBS OF NM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	3834	OTHER		LOVELACE HEALTH PLAN

General Provider Information

NPI Number	:	1225094808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL W CHANG MD

Provider Business Mailing Address
First Line	:	1155 MILL ST # MSM14
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-1576
Country	:	US
Telephone Number	:	775-982-5262
Fax Number	:	775-982-3900

Provider Business Practice Location Address
First Line	:	901 E 2ND ST STE 300
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-1175
Country	:	US
Telephone Number	:	775-982-5000
Fax Number	:	775-982-3901

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

Provider Enumeration Date	:	04/24/2006
Last Update Date	:	04/08/2024

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Directions to “ DANIEL W CHANG MD” Practice Location

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