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Individual

TOM S CHANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
(626) 568-8838
(626) 583-8838
Mailing address
100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
(626) 568-8838
(626) 583-8838

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
A69909
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
A69909
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A699090
BLUE CROSS
05
00A699090
CA
05
1609848969
CA
Enumeration date
02/02/2006
Last updated
08/07/2020
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