Provider Demographics
NPI:1689316648
Name:CHANG, NELSON YOIUM-TSIU (MD)
Entity Type:Individual
Prefix:
First Name:NELSON
Middle Name:YOIUM-TSIU
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 1:1800 N. CALIFORNIA ST.
Mailing Address - Street 2:RE: NELSON CHANG NPI (FM RESIDENT)
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204
Mailing Address - Country:US
Mailing Address - Phone:209-547-7143
Mailing Address - Fax:
Practice Address - Street 1:1800 N. CALIFORNIA ST.
Practice Address - Street 2:RE: NELSON CHANG NPI (FM RESIDENT)
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204
Practice Address - Country:US
Practice Address - Phone:209-547-7143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program