Individual
LAN CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10810 CONNECTICUT AVE, KENSINGTON, MD 20895-2138
(301) 972-7100
Mailing address
8801 HORIZON BLVD NE, SUITE 360, ALBUQUERQUE, NM 87113-1533
(505) 828-4923
(505) 213-0103
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT191020
PA
207W00000X
Ophthalmology Physician
Primary
MD2012-0458
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47278781
—
NM
01
—
P01114041
MEDICARE RAILROAD CARRIER
NM
Enumeration date
07/17/2007
Last updated
11/07/2023
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