Individual
CHANG S JOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 E GRANGER AVE, STE 202, MODESTO, CA 95350-4344
(209) 526-1606
(209) 526-1677
Mailing address
305 E GRANGER AVE, STE 202, MODESTO, CA 95350-4344
(209) 526-1606
(209) 526-1677
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A481920
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A481920
—
CA
Enumeration date
06/01/2005
Last updated
02/22/2008
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