Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | G069785 | CA |
NPI | 1134290612 |
---|---|
Provider Name | Dr. Cindy Jee-Sing Chang |
First Address | Berkeley, CA 94720-4300 |
Second Address | Berkeley, CA 94720-4300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 08/07/2007 |