Active NPI
Sue Chang
- Pharmacist
- Costa Mesa, CA
National Provider Identifier
1043713258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 38510
- Practice address
- 1835 Newport Blvd # C
Costa Mesa, CA 92627-5031 - Phone
- (949) 722-1750
- NPI assigned
- Mar 14, 2018
- Last updated
- Mar 14, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 38510 | CA | Primary |
Addresses
Primary practice location
1835 Newport Blvd # C
Costa Mesa, CA 92627-5031
Mailing address
34 Fort Sumter
Irvine, CA 92620-2530
Phone (714) 746-6724
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38510 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520985600000",
"number": "1043713258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 FORT SUMTER",
"city": "IRVINE",
"state": "CA",
"postal_code": "926202530",
"telephone_number": "714-746-6724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1835 NEWPORT BLVD # C",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926275031",
"telephone_number": "949-722-1750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "SUE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-14",
"last_updated": "2018-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "38510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.