Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | G81662 | CA |
NPI | 1396720207 |
---|---|
Provider Name | Dr. Celia Hwi-Wen Chang |
First Address | Sacramento, CA 95817 |
Second Address | Sacramento, CA 95817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G816620 | MEDI-CAL (01) | CA |
G96677 | (02) | CA |