Provider Demographics
NPI:1417210451
Name:CHANG, CHIA-WEN ANNIE (MD)
Entity Type:Individual
Prefix:
First Name:CHIA-WEN
Middle Name:ANNIE
Last Name:CHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5021 W NOBLE AVE
Mailing Address - Street 2:STE A
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-8310
Mailing Address - Country:US
Mailing Address - Phone:559-627-9393
Mailing Address - Fax:559-627-1624
Practice Address - Street 1:5021 W NOBLE AVE
Practice Address - Street 2:STE A
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-8310
Practice Address - Country:US
Practice Address - Phone:559-627-9393
Practice Address - Fax:559-627-1624
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA142555207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology