Provider Demographics
NPI:1992084545
Name:CHANG, ERIN SAGE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:SAGE
Last Name:CHANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ERIN
Other - Middle Name:SAGE
Other - Last Name:RODEMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4131 GEARY BLVD
Mailing Address - Street 2:ROOM 112
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4131 GEARY BLVD
Practice Address - Street 2:ROOM 112
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3101
Practice Address - Country:US
Practice Address - Phone:877-404-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20306183500000X
CA725151835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist