Provider Demographics
NPI:1508893736
Name:CHANG, PI-NIAN (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:PI-NIAN
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:MCNAMARA CENTER, 200 OAK STREET SE, ROOM 270
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-2820
Mailing Address - Fax:612-624-0997
Practice Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - Street 2:516 DELAWARE STREET SE, PWB FOURTH FLOOR, ROOM 4-100
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-672-7122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2634103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN61-83290OtherMEDICA CHOICE & PRIMARY
MN1016847OtherPREFERRED ONE
MN768055OtherARAZ
MNHP28953OtherHEALTHPARTNERS
MN102725OtherUCARE
MN9G727CHOtherBCBS
MT0491861Medicaid