Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | A96195 | CA |
Y | 207W00000X | Ophthalmologist | ME103859 | FL |
NPI | 1023298643 |
---|---|
Provider Name | Ta Chen Peter Chang |
First Address | Miami, FL 33136-1119 |
Second Address | Miami, FL 33136-1119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2007 |
Last Update Date | 28/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13678 | (02) | CA |