Provider Demographics
NPI:1043623358
Name:CHANG, JAMES JUAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JUAN
Last Name:CHANG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37850 47TH ST E
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552
Mailing Address - Country:US
Mailing Address - Phone:661-285-9473
Mailing Address - Fax:661-285-5040
Practice Address - Street 1:37850 47TH ST E
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552
Practice Address - Country:US
Practice Address - Phone:661-285-9473
Practice Address - Fax:661-285-5040
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70569183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist