MEDICARE: DR. EMILE F CHANG M.D.

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	207P00000X	Emergency Medicine Physician	A115051	CA

General Provider Information

NPI Number	:	1437392909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILE F CHANG M.D.

Provider Business Mailing Address
First Line	:	1851 BENECIA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5011
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1851 BENECIA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5011
Country	:	US
Telephone Number	:	949-872-8581
Fax Number	:

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

Provider Enumeration Date	:	04/14/2009
Last Update Date	:	12/16/2021

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