Provider Demographics
NPI:1699738336
Name:CHANG, ANNIE (MD)
Entity type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:
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 1:7950 KIPLING ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-3923
Mailing Address - Country:US
Mailing Address - Phone:303-422-2305
Mailing Address - Fax:303-422-2306
Practice Address - Street 1:7950 KIPLING ST
Practice Address - Street 2:SUITE 203
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-3923
Practice Address - Country:US
Practice Address - Phone:303-422-2305
Practice Address - Fax:303-422-2306
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38919207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COH28122Medicare UPIN