Active NPI
Sun Chang
- Occupational Therapist
- Los Angeles, CA
National Provider Identifier
1043659931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 19306
- Practice address
- 11500 Nimitz Ave
Los Angeles, CA 90049-3566 - Phone
- (424) 832-8456
- Fax
- (424) 832-8215
- NPI assigned
- Jun 24, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 19306 | CA | Primary |
Addresses
Primary practice location
11500 Nimitz Ave
Los Angeles, CA 90049-3566
Mailing address
1702 Brockton Ave
Unit #2
Los Angeles, CA 90025-7413
Phone (714) 732-2050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19306 | CA | MD | Family Medicine Physician |
| 13305 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RPM Rebah, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372032000000",
"number": "1043659931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1702 BROCKTON AVE",
"address_2": "UNIT #2",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900257413",
"telephone_number": "714-732-2050",
"fax_number": "760-242-1066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11500 NIMITZ AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900493566",
"telephone_number": "424-832-8456",
"fax_number": "424-832-8215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "SUN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-24",
"last_updated": "2013-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "19306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.