Provider Demographics
NPI:1790755569
Name:CHANG, ALBERT BEOMJIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:BEOMJIN
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE 910
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3711
Mailing Address - Country:US
Mailing Address - Phone:949-585-9870
Mailing Address - Fax:949-585-9331
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE 910
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3711
Practice Address - Country:US
Practice Address - Phone:949-585-9870
Practice Address - Fax:949-585-9331
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2014-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA77997207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H16973Medicare UPIN