Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A135218 | CA |
Y | 2080P0201X | Pediatric Allergist | A135218 | CA |
NPI | 1518233808 |
---|---|
Provider Name | Angela Chang |
First Address | San Francisco, CA 94131-2309 |
Second Address | San Francisco, CA 94143-2350 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2012 |
Last Update Date | 28/01/2019 |