Hee Jin Chang Dds, Inc | |
3201 W Olympic Blvd Los Angeles CA 90006-3392 | |
(213) 384-2828 | |
Not Available |
Full Name | Hee Jin Chang Dds, Inc |
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Speciality | Clinic/Center |
Location | 3201 W Olympic Blvd, Los Angeles, California |
Authorized Official Name and Position | Hee Jin Chanag (CEO) |
Authorized Official Contact | 2138230429 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Hee Jin Chang Dds, Inc 3201 W Olympic Blvd Los Angeles CA 90006-3392 Ph: (213) 384-2828 | Hee Jin Chang Dds, Inc 3201 W Olympic Blvd Los Angeles CA 90006-3392 Ph: (213) 384-2828 |
NPI Number | 1871335364 |
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Provider Enumeration Date | 06/06/2024 |
Last Update Date | 06/06/2024 |
Medicare PECOS PAC ID | 6204377328 |
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Medicare Enrollment ID | O20240917001491 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871335364 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Provider Name | Hee Jin Chang |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1740021104 PECOS PAC ID: 8921549049 Enrollment ID: I20240917001564 |
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