Organization
CHRISTINE M CHANG OD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE M CHANG OD (PRESIDENT)
(626) 913-2244
Entity
Organization
Contact information
Practice address
2359 S AZUSA AVE, WEST COVINA, CA 91792
(626) 913-2244
(626) 913-6204
Mailing address
2359 S AZUSA AVE, WEST COVINA, CA 91792
(626) 913-2244
(626) 913-6204
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11110T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD011110T
—
CA
Enumeration date
10/12/2006
Last updated
08/22/2020
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