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NPI Code Detail

MEDICARE: DONG L CHANG M.D., INC.

MEDICARE: DONG L CHANG M.D., INC.
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
1207NI0002XClinical & Laboratory Dermatological Immunology PhysicianA33186ACA
2207NP0225XPediatric Dermatology PhysicianA33186ACA
3207NS0135XProcedural Dermatology PhysicianA33186ACA
4207N00000XDermatology PhysicianA33186ACA
5207ND0101XMOHS-Micrographic Surgery PhysicianA33186ACA
6207ND0900XDermatopathology PhysicianA33186ACA

General Provider Information

NPI Number : 1245479385
Entity Type Code : Organization
Provider Name (Legal Business Name) : DONG L CHANG M.D., INC.
Provider Business Mailing Address
First Line : 100 N SANTA ANITA AVE
Second Line :
City : ARCADIA
State : CA
Zip : 91006-3108
Country : US
Telephone Number : 626-821-5998
Fax Number : 626-821-5990
Provider Business Practice Location Address
First Line : 100 N SANTA ANITA AVE
Second Line :
City : ARCADIA
State : CA
Zip : 91006-3108
Country : US
Telephone Number : 626-821-5998
Fax Number : 626-821-5990
Authorized Official
Title or Position : M.D.
Name : DR. DONG LIANG CHANG
Credential : M.D., INC.
Telephone Number : 626-821-5998
Provider Enumeration Date : 02/12/2009
Last Update Date : 09/19/2023

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