Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A117677 | CA |
N | 207YP0228X | Pediatric Otolaryngology | A117677 | CA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | A117677 | CA |
NPI | 1407172075 |
---|---|
Provider Name | Dr. David Tan-Wei Chang |
First Address | Orange, CA 92868-4203 |
Second Address | Orange, CA 92868-4203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2010 |
Last Update Date | 11/05/2017 |