Provider Demographics
NPI:1851392922
Name:CHANG, KUO HSIEN (MD)
Entity Type:Individual
Prefix:
First Name:KUO HSIEN
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 1:18391 COLIMA RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2730
Mailing Address - Country:US
Mailing Address - Phone:626-965-0696
Mailing Address - Fax:626-965-0265
Practice Address - Street 1:18391 COLIMA RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-2730
Practice Address - Country:US
Practice Address - Phone:626-965-0696
Practice Address - Fax:626-965-0265
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63473207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A634730Medicaid
CAG81149Medicare UPIN
CA00A634730Medicaid