Basic Information
| Provider Information | |||||||||
| NPI: | 1053775098 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHANG | ||||||||
| FirstName: | BRANDON | ||||||||
| MiddleName: | YUN-YAUR | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARMD, BCPS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 CIELO CT | ||||||||
| Address2: | |||||||||
| City: | ORINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945634205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082424758 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11301 WILSHIRE BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104783711 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2016 | ||||||||
| LastUpdateDate: | 06/29/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835X0200X | 75578 | CA | Y | Pharmacy Service Providers | Pharmacist | Oncology |
No ID Information.