Provider Demographics
NPI:1417981796
Name:CHANG, CHRISTOPHER HAN SHENG (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:HAN SHENG
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10833 LE CONTE AVE
Mailing Address - Street 2:DIVISION OF DIGESTIVE DISEASES, UCLA SCHOOL OF MEDICINE
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1684
Mailing Address - Country:US
Mailing Address - Phone:310-206-9053
Mailing Address - Fax:310-267-2774
Practice Address - Street 1:1501 SAN PEDRO DR SE
Practice Address - Street 2:MEDICINE SERVICE, BOX 111
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-5153
Practice Address - Country:US
Practice Address - Phone:505-265-1711
Practice Address - Fax:505-256-2803
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62290207RG0100X
NMMD2015-0819207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A622900OtherMEDICAL PPIN #
CAH67098Medicare UPIN
CAWA62290BMedicare ID - Type UnspecifiedPPIN #
CA00A622900OtherMEDICAL PPIN #