Provider Demographics
NPI:1225356231
Name:CHANG, ALEXANDER A (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:A
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 1:909 HYDE ST STE 230
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4845
Mailing Address - Country:US
Mailing Address - Phone:415-779-8332
Mailing Address - Fax:415-537-9078
Practice Address - Street 1:909 HYDE ST STE 230
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4845
Practice Address - Country:US
Practice Address - Phone:415-779-8332
Practice Address - Fax:415-537-9078
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA127376208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics