Provider Demographics
NPI:1477504405
Name:CHANG, MARGARET AMY (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:AMY
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 1:3939 J ST
Mailing Address - Street 2:STE 104
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3939 J ST
Practice Address - Street 2:STE 106
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3631
Practice Address - Country:US
Practice Address - Phone:916-454-4861
Practice Address - Fax:916-454-3603
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2017-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD64111207W00000X
CAA103453207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0A1034531Medicare PIN
CA0A1034533Medicare PIN
CA0A1034534Medicare PIN
CA0A1034530Medicare PIN
CA0A1034535Medicare PIN
CA0A1034532Medicare PIN
P00648360Medicare PIN