Provider Demographics
NPI:1073899829
Name:CHANG, RODNEY ARNOLD (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:ARNOLD
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 1:2589 JENSEN AVE
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:CA
Mailing Address - Zip Code:93657-2251
Mailing Address - Country:US
Mailing Address - Phone:559-875-4061
Mailing Address - Fax:559-875-9031
Practice Address - Street 1:2589 JENSEN AVE
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:CA
Practice Address - Zip Code:93657-2251
Practice Address - Country:US
Practice Address - Phone:559-875-4061
Practice Address - Fax:559-875-9031
Is Sole Proprietor?:No
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26794183500000X
NV5513183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist