Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A74696 | CA |
NPI | 1013049188 |
---|---|
Provider Name | Dr. Anne Lynn Su Chang |
First Address | Palo Alto, CA 94303-3341 |
Second Address | Stanford, CA 94305-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 08/06/2016 |