Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 02A9833 | CA |
Y | 207L00000X | Anesthesiologist | 2588 | WV |
NPI | 1003058322 |
---|---|
Provider Name | Jennifer Chia-Shin Chang |
First Address | Sunrise, FL 33323-2853 |
Second Address | Logan, WV 25601-3452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2009 |
Last Update Date | 30/11/2011 |