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Provider Information for 1255313771

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. TIEN-LAN CHANG MD

Gender: MALE

Individual NPI: 1255313771

Calendar   Last Updated:  2008-08-04
  Certification Date: 

Details

Name Value
NPI 1255313771
Enumeration Date 2005-11-18
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 105 COMMERCIAL ST
MALDEN, MA 02148-5509
United States

Phone: 781-322-5101 | Fax: 781-322-5820
View Map External Link
Primary Practice Address 105 COMMERCIAL ST
MALDEN, MA 02148-5509
United States

Phone: 781-322-5101 | Fax: 781-322-5820
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID MA 3024253
Other TUFTS HEALTH PLAN MA 710885
Other BCBS MA MA J06703
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 208000000X - Pediatrics MA 53617