Basic Information
| Provider Information | |||||||||
| NPI: | 1629093208 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHANG | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7464 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941207464 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4155027648 | ||||||||
| FaxNumber: | 4155028175 | ||||||||
| Practice Location | |||||||||
| Address1: | 45 CASTRO ST STE 410 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941141027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4155656884 | ||||||||
| FaxNumber: | 4158726723 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2006 | ||||||||
| LastUpdateDate: | 01/13/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | A68382 | CA | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.