Individual
ELLISON CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9990 COUNTY FARM RD # S-3, S-3, RIVERSIDE, CA 92503-3542
(951) 358-4647
Mailing address
10808 FOOTHILL BLVD, S-160 B388, RANCHO CUCAMONGA, CA 91730-3889
(951) 358-4647
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G67488
CA
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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