Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | A91041 | CA |
NPI | 1083781835 |
---|---|
Provider Name | Walter Ting Yu Chang |
First Address | Fontana, CA 92335-6720 |
Second Address | Fontana, CA 92335-6720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 18/11/2021 |