Organization Name: | LIAN S CHANG MD. LLC |
NPI Number: | 1417390204 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LIAN CHANG (OWNER) |
Mailing Address: | 17900 Gulf Blvd Apt 7a Redington Shores |
State: | FL US |
Postal Code: | 337081102 |
Phone Number: | 6514083978 |
Fax Number: | 6516367273 |
NPI Enumeration Date: | 04/10/2013 |
NPI Last Update Date: | 04/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | ME98853 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |