Chang, Jacqueline A.
Chang, Jacqueline A. is an individual health care provider with primary practice located at 9898 Genesee Ave # Amp615 , La Jolla CA 92037-1205. She recently has only one registered license in Allopathic & Osteopathic Physicians / Critical Care Medicine, which is considered as her primary health care specialty. Chang, Jacqueline A. can be contacted via phone (858) 824-5404.Contact Information
Primary practice address
9898 Genesee Ave # Amp615
La Jolla CA 92037-1205
Phone: (858) 824-5404
Fax: (858) 964-3129
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | G80136 | California |
Profile Details
| NPI number | 1053410027 |
|---|---|
| LBN Legal business name | Chang, Jacqueline A. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Jul 21st, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053410027 | NPPES |
| Other | 110180430 | RAILROAD MEDICARE | |
| Other | F569 | RAILROAD MEDICARE | |
| MEDICAID | 00G801360 | RAILROAD MEDICARE |
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