Individual
JESSICA IVY CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5700 E HIGHWAY 90, SIERRA VISTA, AZ 85635-9110
(520) 263-2000
Mailing address
1178 CHISOLM TRAIL DR, DIAMOND BAR, CA 91765-4146
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
007945
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2016
Last updated
06/24/2019
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