Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G64348 | CA |
N | 208600000X | Surgeon | G64348 | CA |
Y | 2086X0206X | Surgical Oncologist | G64348 | CA |
NPI | 1306859038 |
---|---|
Provider Name | Helena R Chang |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90024-6999 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 23/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G643480 | (05) | CA |
C34065 | (02) | CA |