Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | C146039 | CA |
NPI | 1003350984 |
---|---|
Provider Name | Dr. Patricia Yee-Ling Chang |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Santa Monica, CA 90401-2061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2016 |
Last Update Date | 25/07/2017 |