Provider Demographics
NPI:1801999701
Name:CHEN, YING CHANG (MD)
Entity type:Individual
Prefix:
First Name:YING
Middle Name:CHANG
Last Name:CHEN
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 1:735 E OHIO AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3437
Mailing Address - Country:US
Mailing Address - Phone:760-489-0044
Mailing Address - Fax:760-489-0350
Practice Address - Street 1:735 E OHIO AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3437
Practice Address - Country:US
Practice Address - Phone:760-489-0044
Practice Address - Fax:760-489-0350
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA32342207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A323420Medicaid