Provider Demographics
NPI:1063565497
Name:CHANG, DAVID LEE-HUN (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEE-HUN
Last Name:CHANG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1848 SARATOGA AVE
Mailing Address - Street 2:BUILDING 5 / SUITE5A
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-6612
Mailing Address - Country:US
Mailing Address - Phone:408-871-6800
Mailing Address - Fax:408-871-6866
Practice Address - Street 1:1848 SARATOGA AVENUE
Practice Address - Street 2:BUILDING 5/ SUITE 5A
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070
Practice Address - Country:US
Practice Address - Phone:408-871-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 10836 TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist