Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | A104168 | CA |
NPI | 1407062920 |
---|---|
Provider Name | Dr. Eric Yao Chang |
First Address | Newport Beach, CA 92660-3500 |
Second Address | Orange, CA 92868-4231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 14/05/2015 |