Individual
KENNETH C.S. CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1117 E DEVONSHIRE AVE, HEMET, CA 92543-3083
(951) 929-6260
Mailing address
PO BOX 788, HEMET, CA 92546-0788
(951) 929-6260
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A32092
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A320920
—
CA
Enumeration date
04/19/2007
Last updated
07/08/2007
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