Patricia Chang, O.D.
Individual provider Active NPI Optometrist · Millbrae, CA
NPI 1386796480 · NPPES record last updated Mar 18, 2011
Key facts
- NPI
- 1386796480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 6412T (CA)
- Practice address
- 305 Broadway
Millbrae, CA 94030-2509 - Phone
- (650) 697-2475
- Fax
- (650) 692-7154
- NPI assigned
- Jan 17, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6412T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elena Wong O.D., Inc. | Optometrist | Current |
Accepting new patients |
| Palo Alto Medical Foundation | Past |
Accepting new patients |
Locations
1019 Alameda de las Pulgas
Belmont, CA 94002
Phone (650) 594-1019
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6412T | CA | Yes |
Addresses
Primary practice location
305 Broadway
Millbrae, CA 94030-2509
Mailing address
305 Broadway
Millbrae, CA 94030-2509
Phone (650) 697-2475
Other providers in Millbrae, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.