Provider Demographics
NPI:1174506380
Name:CHANG, YIH (MD)
Entity Type:Individual
Prefix:
First Name:YIH
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2147 MOWRY AVE
Mailing Address - Street 2:STE D3
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1724
Mailing Address - Country:US
Mailing Address - Phone:510-648-2087
Mailing Address - Fax:
Practice Address - Street 1:2147 MOWRY AVE
Practice Address - Street 2:STE D3
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1724
Practice Address - Country:US
Practice Address - Phone:510-648-2087
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69040207RE0101X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism