| Beverly Chang Md, Inc | |
|
1700 Eureka Rd Ste 140a Roseville CA 95661-7720 | |
| (916) 303-4353 | |
| (916) 303-4356 |
| Full Name | Beverly Chang Md, Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1700 Eureka Rd Ste 140a, Roseville, California |
| Authorized Official Name and Position | Beverly Anne Chang (OWNER) |
| Authorized Official Contact | 9163034353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beverly Chang Md, Inc 1420 E Roseville Pkwy Ste 140-313 Roseville CA 95661-3078 Ph: () - | Beverly Chang Md, Inc 1700 Eureka Rd Ste 140a Roseville CA 95661-7720 Ph: (916) 303-4353 |
| NPI Number | 1003272287 |
|---|---|
| Provider Enumeration Date | 01/04/2016 |
| Last Update Date | 08/03/2022 |
| Certification Date | 08/03/2022 |
| Medicare PECOS PAC ID | 0749584696 |
|---|---|
| Medicare Enrollment ID | O20160212001320 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003272287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A118995 (California) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | A118995 (California) | Secondary |
| Provider Name | Beverly A Chang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063716009 PECOS PAC ID: 9830327774 Enrollment ID: I20140122001161 |
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