Chang, Justin

Chang, Justin is an individual health care provider with primary practice located at 4720 Peachtree Industrial Blvd Ste 206, Norcross GA 30071-5735. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Chang, Justin can be contacted via phone (770) 300-0559.

Contact Information

Primary practice address
4720 Peachtree Industrial Blvd Ste 206 Norcross GA 30071-5735
Fax: (770) 300-9176
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 001753 Georgia
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 001753 Georgia

Profile Details

NPI number 1457344186
LBN Legal business name Chang, Justin
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2005
Last updated Jul 28th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457344186 NPPES
Georgia MEDICAID 000980735A

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