Provider Demographics
NPI:1447356621
Name:CHANG, EING-MIN (MD)
Entity type:Individual
Prefix:DR
First Name:EING-MIN
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2690 PACIFIC A VE.
Mailing Address - Street 2:STE 290
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2631
Mailing Address - Country:US
Mailing Address - Phone:562-426-8185
Mailing Address - Fax:562-988-8556
Practice Address - Street 1:2690 PACIFIC A VE.
Practice Address - Street 2:STE 290
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2631
Practice Address - Country:US
Practice Address - Phone:562-426-8185
Practice Address - Fax:562-988-8556
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39572207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA88496Medicare UPIN