Individual
HARVEY CHUNG-DER CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4301 N STAR WAY, MODESTO, CA 95356-9262
(209) 577-1200
(209) 577-6517
Mailing address
PO BOX 576768, MODESTO, CA 95357-6768
(209) 577-1200
(209) 577-6517
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
C50076
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
C50076
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51897
LICENSE
MA
01
—
C50076
LICENSE
CA
01
—
P00037347
RAILROAD
CA
Enumeration date
06/22/2005
Last updated
02/19/2025
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