Shi-Hwa William Chang, MD
Individual provider Active NPI Ophthalmology Physician · Truckee, CA
NPI 1477548667 · NPPES record last updated Jan 3, 2024
Key facts
- NPI
- 1477548667
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ophthalmology Physician 207W00000X
- License
- A48531 (CA)
- Practice address
- 12824 Stockholm Way
Truckee, CA 96161-6943 - Phone
- (209) 596-2266
- NPI assigned
- Sep 14, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 199170 | NY | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Retina Specialist of the Finger Lakes | Ophthalmology | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | A48531 | CA | Yes |
| Ophthalmology Physician | 207W00000X | 199170 | NY |
Addresses
Primary practice location
12824 Stockholm Way
Truckee, CA 96161-6943
Mailing address
12824 Stockholm Way
Truckee, CA 96161-6943
Phone (209) 596-2266
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A485310 | Medicaid | CA | |
| 01731795 | Medicaid | NY |
Other providers in Truckee, CA
- Aenora Casper
- Lucille Castillo
- Cep America - California
- Erika Rodrigues Cervantes
- Krithika Chandrasekaran
- Claudia Dolores Chavarria
- Anna Choi
- Chelsea Ndidiamaka Chukwunyere
- Kylie Clark
- Charleston Clarke
All providers in Truckee, CA · Ophthalmology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.