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NPI Code Detail

MEDICARE: PHILIP CHANG, DDS, INC.

MEDICARE: PHILIP CHANG, DDS, 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
1122300000XDentist62595CA

General Provider Information

NPI Number : 1386013209
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHILIP CHANG, DDS, INC.
Provider Business Mailing Address
First Line : 18208 VILLA CLARA ST
Second Line :
City : ROWLAND HGHTS
State : CA
Zip : 91748-4435
Country : US
Telephone Number : 626-217-4542
Fax Number :
Provider Business Practice Location Address
First Line : 8038 GARVEY AVE STE B
Second Line :
City : ROSEMEAD
State : CA
Zip : 91770-2483
Country : US
Telephone Number : 626-571-7000
Fax Number : 626-571-8454
Authorized Official
Title or Position : PRESIDENT
Name : DR. PHILIP CHANG
Credential : D.D.S.
Telephone Number : 626-217-4542
Provider Enumeration Date : 09/22/2015
Last Update Date : 09/22/2015

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Directions to “PHILIP CHANG, DDS, INC. ” Practice Location

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