Individual provider Active NPI

Tiffany Chang

  • Obstetrics & Gynecology Physician
  • Beverly Hills, CA
National Provider Identifier
1144873266
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A198448 Issued in CA
Practice address
9720 Wilshire Blvd Ste LL
Beverly Hills, CA 90212-2028
Phone
(310) 432-6640
NPI assigned
Jul 17, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A198448 CA Primary

Addresses

Primary practice location

9720 Wilshire Blvd Ste LL
Beverly Hills, CA 90212-2028

Mailing address

9720 Wilshire Blvd Ste LL
Beverly Hills, CA 90212-2028
Phone (310) 432-6640

Other practice location 1

421 N Rodeo Dr Ph 1
Beverly Hills, CA 90210-4531
Phone (310) 432-6640

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250218002494 CA Practitioner - Obstetrics/Gynecology 4981124179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Tulane University School of Medicine, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Rodeo Medical GroupGroup PAC ID 5294027744, 7 clinicians

Practice addresses (Care Compare)

9720 Wilshire Blvd
Suite LL
Beverly Hills, CA 90212-2028
Phone (310) 432-6640

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A198448CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rodeo Medical Group Obstetrics & Gynecology CurrentSince Dec 14, 2024 Accepting new patients

Locations

421 N Rodeo Dr
Ph 1
Beverly Hills, CA 90210
Phone (310) 432-6640

9720 Wilshire Blvd
Ste Ll
Beverly Hills, CA 90212
Phone (310) 432-6640

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1144873266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9720 WILSHIRE BLVD STE LL",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122028",
            "telephone_number": "310-432-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9720 WILSHIRE BLVD STE LL",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122028",
            "telephone_number": "310-432-6640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 N Rodeo Dr Ph 1",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902104531",
            "country_code": "US",
            "telephone_number": "310-432-6640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "TIFFANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A198448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.