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Organization
GREEN PEACE MEDICAL GROUP
Active
Organization
GREEN PEACE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHENG H CHANG MD (OWNER)
(626) 573-0055
Entity
Organization
Contact information
Practice address
330 W LAS TUNAS DR, SUITE 3, SAN GABRIEL, CA 91776-1213
(626) 573-0055
(626) 573-4087
Mailing address
330 W LAS TUNAS DR, SUITE 3, SAN GABRIEL, CA 91776-1213
(626) 573-0055
(626) 573-4087
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A33409
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0091430
—
CA
Enumeration date
09/20/2005
Last updated
06/16/2008
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