Provider Demographics
NPI:1497063481
Name:CHANG, CHU-PING (MD)
Entity Type:Individual
Prefix:DR
First Name:CHU-PING
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
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:PO BOX 1464
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-1464
Mailing Address - Country:US
Mailing Address - Phone:206-232-6759
Mailing Address - Fax:206-232-6759
Practice Address - Street 1:8383 SEASHORE DR
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-5651
Practice Address - Country:US
Practice Address - Phone:206-232-6759
Practice Address - Fax:206-232-6759
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA16059207L00000X
CAA35397207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology