Provider Demographics
NPI:1235572603
Name:CHANG, KYUNG H (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KYUNG
Middle Name:H
Last Name:CHANG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:9551 S UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-8117
Mailing Address - Country:US
Mailing Address - Phone:303-470-6445
Mailing Address - Fax:303-346-6302
Practice Address - Street 1:9551 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126
Practice Address - Country:US
Practice Address - Phone:303-470-6445
Practice Address - Fax:303-346-6302
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13617183500000X
NV08202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist