Provider Demographics
NPI:1255529129
Name:DAVID CHANG, M.D. ORTHO SPINE INC.
Entity type:Organization
Organization Name:DAVID CHANG, M.D. ORTHO SPINE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-448-7890
Mailing Address - Street 1:13160 MINDANAO WAY
Mailing Address - Street 2:SUITE 325
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6358
Mailing Address - Country:US
Mailing Address - Phone:310-448-7890
Mailing Address - Fax:310-448-7854
Practice Address - Street 1:13160 MINDANAO WAY
Practice Address - Street 2:SUITE 325
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-6358
Practice Address - Country:US
Practice Address - Phone:310-448-7890
Practice Address - Fax:310-448-7854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty