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NPI Code Detail

MEDICARE: DR. CARL J. CHANG M.D.

MEDICARE: DR. CARL J. 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
1207N00000XDermatology PhysicianA91493CA

General Provider Information

NPI Number : 1891983078
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARL J. CHANG M.D.
Provider Business Mailing Address
First Line : PO BOX 1938
Second Line :
City : ARCADIA
State : CA
Zip : 91077-1938
Country : US
Telephone Number : 626-821-5998
Fax Number : 626-821-5990
Provider Business Practice Location Address
First Line : 100 N SANTA ANITA AVE
Second Line :
City : ARCADIA
State : CA
Zip : 91006-3108
Country : US
Telephone Number : 626-821-5998
Fax Number : 626-821-5990
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2007
Last Update Date : 07/13/2011

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