Active NPI
Paul Chang
- Orthopedic Physical Therapist
- Pasadena, CA
National Provider Identifier
1669924890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT291793
- Practice address
- 630 S Raymond Ave Unit 120
Pasadena, CA 91105-3283 - Phone
- (626) 397-3801
- NPI assigned
- Nov 4, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT291793 | CA | Primary |
Addresses
Primary practice location
630 S Raymond Ave Unit 120
Pasadena, CA 91105-3283
Mailing address
630 S Raymond Ave Unit 120
Pasadena, CA 91105-3283
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT291793 | CA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724716800000",
"number": "1669924890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 S RAYMOND AVE UNIT 120",
"city": "PASADENA",
"state": "CA",
"postal_code": "911053283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 S RAYMOND AVE UNIT 120",
"city": "PASADENA",
"state": "CA",
"postal_code": "911053283",
"telephone_number": "626-397-3801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-11-04",
"last_updated": "2024-08-27",
"certification_date": "2024-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "PT291793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.