Chong C Chang, M.D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

MD13588 Issued in OR

Practice address

19875 SW 65TH Ave
Suite 260
Tualatin, OR 97062-8353

Phone

(503) 691-1743

Fax

(503) 691-0983

NPI assigned

Mar 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1639201635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19875 SW 65TH AVE",
            "address_2": "SUITE 260",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628353",
            "telephone_number": "503-691-1743",
            "fax_number": "503-691-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19875 SW 65TH AVE",
            "address_2": "SUITE 260",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628353",
            "telephone_number": "503-691-1743",
            "fax_number": "503-691-0983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "CHONG",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD13588",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "OR",
            "license": "MD13588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104752",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Cate, PA
• Center Pharmacy & Sterile Products Inc
• Ana Mercedes Cerritos-Sanchez
• Mona Chandler, LMT
• Anya H Chang, N.D.
• Gina Chang, L.AC.
• Nicholas Chang
• David Richard Charlton, LCSW
• Bania A Chavez Maciel
• Celeste Elise Cheek, PHYSICAL THERAPIST

• Gynecology Physician in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Gynecology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.