Organization Active NPI

Patricia Chang, MD Inc.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1659612398
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G76535 Issued in CA
Legal business name
PATRICIA CHANG, MD INC.
Practice address
2080 Century Park E
Suite 1609
Los Angeles, CA 90067-2001
Phone
(310) 556-8899
Fax
(310) 553-2422
NPI assigned
Mar 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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

Authorized official

Name
Kristen Smith
Title
Administrator
Phone
(310) 553-4982

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X G76535 CA Primary

Addresses

Primary practice location

2080 Century Park E
Suite 1609
Los Angeles, CA 90067-2001

Mailing address

2080 Century Park E
Suite 1609
Los Angeles, CA 90067-2001
Phone (310) 556-8899

Other identifiers 1

IdentifierTypeStateIssuer
G76535OtherCAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130424000493 CA Part B Supplier - Clinic/Group Practice 2668618471 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362441600000",
    "number": "1659612398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E",
            "address_2": "SUITE 1609",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672001",
            "telephone_number": "310-556-8899",
            "fax_number": "310-553-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E",
            "address_2": "SUITE 1609",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672001",
            "telephone_number": "310-556-8899",
            "fax_number": "310-553-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA CHANG, MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-05",
        "last_updated": "2013-03-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "310-553-4982"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G76535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G76535",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.