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NPI Code Detail

MEDICARE: MR. PAUL CHANG

MEDICARE: MR. PAUL CHANG
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
11041C0700XClinical Social Worker080505NY

General Provider Information

NPI Number : 1396197612
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL CHANG
Provider Business Mailing Address
First Line : 1150 GRASS POND PL UNIT 103
Second Line :
City : HENDERSON
State : NV
Zip : 89002-9466
Country : US
Telephone Number : 516-241-1954
Fax Number :
Provider Business Practice Location Address
First Line : 4461 E CHARLESTON BLVD RM 188
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-5537
Country : US
Telephone Number : 516-241-1954
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2016
Last Update Date : 07/18/2023

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Directions to “ MR. PAUL CHANG ” Practice Location

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