Provider Demographics
NPI:1811284193
Name:CHANG, ELISA LEE (MD)
Entity type:Individual
Prefix:DR
First Name:ELISA
Middle Name:LEE
Last Name:CHANG
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Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 1449
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92822-1449
Mailing Address - Country:US
Mailing Address - Phone:714-996-1633
Mailing Address - Fax:714-996-2967
Practice Address - Street 1:960 E GREEN ST STE 105
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2443
Practice Address - Country:US
Practice Address - Phone:626-304-0782
Practice Address - Fax:626-310-0552
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2023-10-27
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Provider Licenses
StateLicense IDTaxonomies
CAA117197207RI0200X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease