Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 7058 | NV |
Y | 213EG0000X | General Practice | 7058 | NV |
NPI | 1003265091 |
---|---|
Provider Name | Ning Chang |
First Address | Henderson, NV 89052-0438 |
Second Address | Henderson, NV 89052-0438 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2016 |
Last Update Date | 14/07/2021 |