Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | ME134895 | FL |
NPI | 1205850732 |
---|---|
Provider Name | Christopher C Chang |
First Address | Miramar, FL 33025-3925 |
Second Address | Hollywood, FL 33021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 17/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
023747000 | (05) | FL |