Active NPI
Yong Soon Chang, PHARMD
- Pharmacist
- Perris, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 76368
- Practice address
- 404 E 4TH St
Perris, CA 92570-2201 - Phone
- (217) 721-3435
- NPI assigned
- Aug 20, 2014
- Last updated
- Mar 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18381 | NV | |
| Pharmacist | 183500000X | RP00007930 | NM | |
| Pharmacist | 183500000X | 55516 | TX | |
| Pharmacist | 183500000X | 76368 | CA | Primary |
Addresses
Primary practice location
404 E 4TH St
Perris, CA 92570-2201
Mailing address
5450 Beach Blvd Ste 110
Buena Park, CA 90621-1277
Phone (217) 721-3435
Other practice location 1
1900 Bataan Memorial E
Las Cruces, NM 88011-6011
Phone (575) 522-8603
Other practice location 2
12873 Harbor Blvd Ste M3
Garden Grove, CA 92840-5848
Phone (217) 721-3435
Other practice location 3
5450 Beach Blvd Ste 110
Buena Park, CA 90621-1277
Phone (217) 721-3435
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76368 | CA | MD | Pharmacist |
| RP00007930 | NM | MD | Pharmacist |
| 55516 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meds Envy Inc | Past | Accepting new patients | |
| Meds Envy Inc | Past | Accepting new patients | |
| Meds Envy, Inc. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Community/Retail Pharmacy
- Garden Grove, CA
- NPI 1487167730
-
- Community/Retail Pharmacy
- Buena Park, CA
- NPI 1669985917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1053710616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5450 BEACH BLVD STE 110",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906211277",
"telephone_number": "217-721-3435",
"fax_number": "915-943-1577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 E 4TH ST",
"city": "PERRIS",
"state": "CA",
"postal_code": "925702201",
"telephone_number": "217-721-3435"
}
],
"practiceLocations": [
{
"address_1": "1900 Bataan Memorial E",
"address_purpose": "LOCATION",
"city": "Las Cruces",
"state": "NM",
"postal_code": "880116011",
"country_code": "US",
"telephone_number": "575-522-8603",
"fax_number": "575-522-3419",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12873 Harbor Blvd Ste M3",
"address_purpose": "LOCATION",
"city": "Garden Grove",
"state": "CA",
"postal_code": "928405848",
"country_code": "US",
"telephone_number": "217-721-3435",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5450 Beach Blvd Ste 110",
"address_purpose": "LOCATION",
"city": "Buena Park",
"state": "CA",
"postal_code": "906211277",
"country_code": "US",
"telephone_number": "217-721-3435",
"fax_number": "915-943-1577",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHANG",
"first_name": "YONG SOON",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-20",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "18381",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "RP00007930",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "55516",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "76368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.