Individual
FONG CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 E 13TH ST STE D, MERCED, CA 95341-6211
(209) 386-1096
Mailing address
3433 W SHAW AVE STE 102, FRESNO, CA 93711-3229
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
284206
CA
Other
Enumeration date
10/21/2019
Last updated
10/29/2019
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