Individual provider Active NPI

Chin Jung Jien Chang

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1629518246
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005509 Issued in CA
Practice address
501 Washington St
San Diego, CA 92103-2231
Phone
(619) 278-3360
NPI assigned
Mar 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95005509 CA Primary

Addresses

Primary practice location

501 Washington St
San Diego, CA 92103-2231

Mailing address

10790 Rancho Bernardo Rd
Mail Drop 4S-205
San Diego, CA 92127-5705
Phone (619) 278-3300

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170327001603 CA Practitioner - Nurse Practitioner 1759666118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Loma Linda University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

2205 Vista Way
Oceanside, CA 92054-5661

380 Stevens Ave
Suite 100
Solana Beach, CA 92075-2068
Phone (858) 554-9800

501 Washington St
San Diego, CA 92103-2239
Phone (619) 278-3300

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9896 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health CurrentSince Apr 1, 2017 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Apr 1, 2017 Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
#4S205
San Diego, CA 92127
Phone (858) 605-7171

501 Washington St
San Diego, CA 92103
Phone (619) 278-3300

Interoperability endpoints

  • Direct secure messaging: cchang31465@scrippshlth.medalliesdirect.net

Organizations & group practices 6

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": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1629518246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "address_2": "MAIL DROP 4S-205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "619-278-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032231",
            "telephone_number": "619-278-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIEN CHANG",
        "first_name": "CHIN JUNG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-01",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.