Provider Demographics
NPI:1396720207
Name:CHANG, CELIA HWI-WEN (MD)
Entity type:Individual
Prefix:DR
First Name:CELIA
Middle Name:HWI-WEN
Last Name:CHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2825 50TH STREET
Mailing Address - Street 2:M.I.N.D. INSTITUTE
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817
Mailing Address - Country:US
Mailing Address - Phone:916-703-0258
Mailing Address - Fax:916-703-0242
Practice Address - Street 1:2825 50TH STREET
Practice Address - Street 2:M.I.N.D. INSTITUTE
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-703-0258
Practice Address - Fax:916-703-0242
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG816622084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G816620OtherMEDI-CAL
CAG96677Medicare UPIN