Provider Demographics
NPI:1194739128
Name:CHANG, YUAN-FEI FAYE (MD)
Entity type:Individual
Prefix:
First Name:YUAN-FEI
Middle Name:FAYE
Last Name:CHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18575 GALE AVE STE 128
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91748-1382
Mailing Address - Country:US
Mailing Address - Phone:626-912-5335
Mailing Address - Fax:626-912-3411
Practice Address - Street 1:18575 GALE AVE STE 128
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-1382
Practice Address - Country:US
Practice Address - Phone:626-912-5335
Practice Address - Fax:626-912-3411
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG73324207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F62275Medicare UPIN