Provider Demographics
NPI:1962800870
Name:JUNE K CHANG
Entity type:Organization
Organization Name:JUNE K CHANG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-559-9760
Mailing Address - Street 1:4000 W. RIVERSIDE DR
Mailing Address - Street 2:B
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505
Mailing Address - Country:US
Mailing Address - Phone:818-559-9760
Mailing Address - Fax:818-559-1366
Practice Address - Street 1:4000 W RIVERSIDE DR
Practice Address - Street 2:B
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4328
Practice Address - Country:US
Practice Address - Phone:818-559-9760
Practice Address - Fax:818-559-1366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL.AC 8501284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital