Individual provider Active NPI

Tien-Yu Chang, M.D.

  • Anesthesiology Physician
  • Panorama City, CA
National Provider Identifier
1225213515
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A93643 Issued in CA
Practice address
13652 Cantara St
Panorama City, CA 91402-5423
Phone
(818) 375-2809
NPI assigned
Jan 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A93643 CA Primary

Addresses

Primary practice location

13652 Cantara St
Panorama City, CA 91402-5423

Mailing address

3961 Via Marisol Apt 219
Los Angeles, CA 90042-5086
Phone (323) 687-1899

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
I20080501000720 CA Practitioner - Anesthesiology 6103905120 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Southern California Keck School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayside Anesthesia Medical GroupGroup PAC ID 2466490560, 47 clinicians

Practice addresses (Care Compare)

1328 22ND St
St Johns Hospital
Santa Monica, CA 90404-2091
Phone (310) 477-2465

Hospital & facility affiliations

  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
93643CAMDMarriage & Family Therapist
13751NVMDRegistered Nurse
A93643CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Anesthesia Medical Group CurrentSince Nov 1, 2011 Accepting new patients
Torrance Anesthesia Medical Group Inc. Anesthesiology CurrentSince Feb 19, 2024 Accepting new patients
Sheridan Drozdow Healthcare of Nevada PC Anesthesiology Past Accepting new patients
Golden State Anesthesia Consultants, Inc. Anesthesiology Past Accepting new patients

Locations

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

1328 22nd St
Santa Monica, CA 90404
Phone (310) 829-5511

3330 Lomita Blvd
Torrance, CA 90505
Phone (310) 517-4675

22525 Maple Ave
Ste 101
Torrance, CA 90505
Phone (310) 602-5480

Organizations & group practices 4

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 1

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": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1225213515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3961 VIA MARISOL APT 219",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900425086",
            "telephone_number": "323-687-1899",
            "fax_number": "323-226-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13652 CANTARA ST",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914025423",
            "telephone_number": "818-375-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "TIEN-YU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-04",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A93643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panorama City, CA

Sources for this page

Verify at the official NPI Registry.