Provider Demographics
NPI:1205196474
Name:KUO HSIEN CHANG,MD.INC.
Entity Type:Organization
Organization Name:KUO HSIEN CHANG,MD.INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KUO HSIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-965-0696
Mailing Address - Street 1:18391 COLIMA RD
Mailing Address - Street 2:STE 202
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2730
Mailing Address - Country:US
Mailing Address - Phone:626-965-0696
Mailing Address - Fax:626-965-0265
Practice Address - Street 1:18391 COLIMA RD
Practice Address - Street 2:STE 202
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-2730
Practice Address - Country:US
Practice Address - Phone:626-965-0696
Practice Address - Fax:626-965-0265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA444-2883-7261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service