Organization
SOUTH COUNTY KIDNEY AND ENDOCRINE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND KU JAY CHANG (MEDICAL DIRECTOR)
(949) 916-9100
Entity
Organization
Contact information
Practice address
23141 MOULTON PKWY STE 102, LAGUNA HILLS, CA 92653-1241
(949) 916-9100
(949) 916-0091
Mailing address
23141 MOULTON PKWY #102, LAGUNA HILLS, CA 92653
(949) 916-9100
(949) 916-0091
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
202278889
CA
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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