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Organization
WILLIAM CHANG OD, INC
Active
Organization
WILLIAM CHANG OD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM CHANG OD (OWNER)
(626) 291-2020
Entity
Organization
Contact information
Practice address
417 S SAN GABRIEL BLVD, SUITE B, SAN GABRIEL, CA 91776-1967
(626) 291-2020
(626) 585-2905
Mailing address
417 S SAN GABRIEL BLVD, SUITE B, SAN GABRIEL, CA 91776-1967
(626) 291-2020
(626) 585-2905
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
13713
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255669057
—
CA
01
—
CR713Z
MEDICARE PTAN
CA
Enumeration date
12/07/2009
Last updated
09/16/2021
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