Provider Demographics
NPI:1962758706
Name:CHANG, KUEI-YU (OD)
Entity type:Individual
Prefix:DR
First Name:KUEI-YU
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8519 IRVINE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4298
Mailing Address - Country:US
Mailing Address - Phone:949-585-9403
Mailing Address - Fax:949-585-9162
Practice Address - Street 1:8519 IRVINE CENTER DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4298
Practice Address - Country:US
Practice Address - Phone:949-585-9403
Practice Address - Fax:949-585-9162
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2024-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15157TLG152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management