Individual provider Active NPI

Shang-Tian Chuang, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • Los Angeles, CA
National Provider Identifier
1598976680
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
20A8851 Issued in CA
Practice address
4060 Whittier Blvd
Los Angeles, CA 90023-2526
Phone
(323) 260-4184
Fax
(419) 866-5453
NPI assigned
May 24, 2007
Last updated
Jul 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X OS10083 FL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 20A8851 CA Primary

Addresses

Primary practice location

4060 Whittier Blvd
Los Angeles, CA 90023-2526

Mailing address

4060 Whittier Blvd
Los Angeles, CA 90023-2526
Phone (323) 260-4184

Other identifiers 2

IdentifierTypeStateIssuer
278580300MedicaidFL
78214OtherFLBCBS

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
I20110817000865 CA Practitioner - Pathology 7012001704 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-Valley Urology Medical GroupGroup PAC ID 2668449125, 10 clinicians

Practice addresses (Care Compare)

25495 Medical Ctr Dr
Suite 204
Murrieta, CA 92562-4903
Phone (951) 698-1901

4060 E Whittier Blvd
Los Angeles, CA 90023-2526

4060 Whittier Blvd
Los Angeles, CA 90023-2526
Phone (323) 260-4184

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8851CAMDAddiction (Substance Use Disorder) Counselor
OS10083FLMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Path MD Inc CurrentSince May 1, 2017 Accepting new patients
Tri Valley Urology Medical Group CurrentSince May 1, 2018 Accepting new patients
Shang-Tian Chuang, D.O., Inc. Anatomic Pathology & Clinical Pathology CurrentSince Jun 23, 2017 Accepting new patients

Locations

931 Buena Vista St
Ste 200A
Duarte, CA 91010
Phone (818) 321-2745

4060 Whittier Blvd
Los Angeles, CA 90023
Phone (323) 224-2040

25495 Medical Center Dr
Ste 204
Murrieta, CA 92562
Phone (951) 698-1901

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1598976680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900232526",
            "telephone_number": "323-260-4184",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900232526",
            "telephone_number": "323-260-4184",
            "fax_number": "419-866-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUANG",
        "first_name": "SHANG-TIAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "OS10083",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "20A8851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278580300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "78214",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.