MEDICARE: DR. CHARLENE D CHANG-SMITH MD

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	207W00000X	Ophthalmology Physician	A070256	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871550939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLENE D CHANG-SMITH MD

Provider Business Mailing Address
First Line	:	280 FAIRHILL DR
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95966-9504
Country	:	US
Telephone Number	:	530-538-8513
Fax Number	:

Provider Business Practice Location Address
First Line	:	2809 OLIVE HWY
Second Line	:	STE 250
City	:	OROVILLE
State	:	CA
Zip	:	95966-6131
Country	:	US
Telephone Number	:	530-532-7650
Fax Number	:

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	07/08/2007

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