MEDICARE: DANIEL 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	58826	AZ

General Provider Information

NPI Number	:	1578959862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL CHANG M.D.

Provider Business Mailing Address
First Line	:	6220 W BELL RD STE 100C
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-3896
Country	:	US
Telephone Number	:	602-547-7335
Fax Number	:

Provider Business Practice Location Address
First Line	:	6220 W BELL RD STE 100C
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-3896
Country	:	US
Telephone Number	:	602-547-7335
Fax Number	:

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

Provider Enumeration Date	:	04/13/2015
Last Update Date	:	01/25/2023

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Directions to “ DANIEL CHANG M.D.” Practice Location

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