Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | A71793 | CA |
NPI | 1043266240 |
---|---|
Provider Name | David Flemming Chang |
First Address | Riverside, CA 92505-3071 |
Second Address | Wildomar, CA 92595-7512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 05/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A717930 | (05) | CA |
H85323 | (02) | CA |