MEDICARE: DR. SOONG OK 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
1	183500000X	Pharmacist	45540	CA

General Provider Information

NPI Number	:	1790437622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SOONG OK CHANG

Provider Business Mailing Address
First Line	:	6901 E RUTGERS DR
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92807-5116
Country	:	US
Telephone Number	:	714-863-9556
Fax Number	:

Provider Business Practice Location Address
First Line	:	3501 S HARBOR BLVD STE 167
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-6940
Country	:	US
Telephone Number	:	714-557-2982
Fax Number	:	714-557-2336

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

Provider Enumeration Date	:	01/21/2022
Last Update Date	:	01/31/2022

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Directions to “ DR. SOONG OK CHANG ” Practice Location

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