Chang Broderick, Grace

Chang Broderick, Grace is an individual health care provider with primary practice located at 2521 Michelle Dr , Tustin CA 92780-7014. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Chang Broderick, Grace can be contacted via phone (888) 988-2800.

Contact Information

Primary practice address
2521 Michelle Dr Tustin CA 92780-7014
Phone: (888) 988-2800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 135716 California

Profile Details

NPI number 1548525264
LBN Legal business name Chang Broderick, Grace
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2012
Last updated Nov 22nd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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