Provider Demographics
NPI:1982027868
Name:CHANG, JUNN YANN (MD)
Entity Type:Individual
Prefix:MR
First Name:JUNN
Middle Name:YANN
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 1:9431 FEATHERHILL DR.
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:92861
Mailing Address - Country:US
Mailing Address - Phone:714-637-4326
Mailing Address - Fax:
Practice Address - Street 1:9431 FEATHERHILL DR.
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:CA
Practice Address - Zip Code:92861
Practice Address - Country:US
Practice Address - Phone:714-637-4326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-35827208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
C-35450Medicare PIN