Provider Demographics
NPI:1801986625
Name:CHANG, STEVE H (MD)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:H
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5420 KIETZKE LN
Mailing Address - Street 2:STE 103
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2063
Mailing Address - Country:US
Mailing Address - Phone:775-997-9418
Mailing Address - Fax:
Practice Address - Street 1:5420 KIETZKE LN
Practice Address - Street 2:STE 103
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2063
Practice Address - Country:US
Practice Address - Phone:775-997-9418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95100207W00000X
NV12891207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV12891OtherSTATE MEDICAL LICENSE
CAA95100OtherSTATE MEDICAL LICENSE
CAA95100OtherSTATE MEDICAL LICENSE