Provider Demographics
NPI:1407062920
Name:CHANG, ERIC YAO (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:YAO
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2549 EASTBLUFF DR # 183
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3500
Mailing Address - Country:US
Mailing Address - Phone:310-923-1664
Mailing Address - Fax:
Practice Address - Street 1:1120 W LA VETA AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4231
Practice Address - Country:US
Practice Address - Phone:657-210-4096
Practice Address - Fax:657-210-4233
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1041682081P2900X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine