Individual provider Active NPI

Michael S Chang, OD

  • Optometrist
  • Artesia, CA
National Provider Identifier
1144217878
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11341T Issued in CA
Practice address
17801 Pioneer Blvd
Suite F
Artesia, CA 90701-3962
Phone
(562) 467-0813
Fax
(562) 467-0816
NPI assigned
Sep 27, 2005
Last updated
Jan 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11341T CA Primary

Addresses

Primary practice location

17801 Pioneer Blvd
Suite F
Artesia, CA 90701-3962

Mailing address

17801 Pioneer Blvd
Suite F
Artesia, CA 90701-3962
Phone (562) 467-0813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080306000676 CA Practitioner - Optometry 1557446184 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11341TCAMDOptometrist
11341CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Michael Chang Optometry Corporation Optometrist CurrentSince Feb 25, 2024 Accepting new patients
Dr. Michael S. Chang O.D. Inc. Optometrist CurrentSince Oct 1, 2003 Accepting new patients

Locations

661 N Euclid St
Anaheim, CA 92801
Phone (714) 817-0606

17801 Pioneer Blvd
Ste F
Artesia, CA 90701
Phone (562) 239-2240

2700 Alton Pkwy
Ste 221
Irvine, CA 92606
Phone (562) 716-8986

Organizations & group practices 2

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1144217878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17801 PIONEER BLVD",
            "address_2": "SUITE F",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907013962",
            "telephone_number": "562-467-0813",
            "fax_number": "562-467-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17801 PIONEER BLVD",
            "address_2": "SUITE F",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907013962",
            "telephone_number": "562-467-0813",
            "fax_number": "562-467-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11341T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Artesia, CA

Sources for this page

Verify at the official NPI Registry.