Organization
CHANG ORTHOPEDICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOO ILL CHANG M.D. (ORTHOPEDIC SURGEON)
(559) 435-7100
Entity
Organization
Contact information
Practice address
1381 E HERNDON AVE, 102, FRESNO, CA 93720-3307
(559) 435-7100
Mailing address
1381 E HERNDON AVE, 102, FRESNO, CA 93720-3307
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A31127
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0015350
—
CA
Enumeration date
10/18/2007
Last updated
10/18/2007
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