Organization Active NPI

Sheng H. Chang, M.D., Inc.

  • Clinic/Center
  • San Gabriel, CA
National Provider Identifier
1679804728
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
A 33409 Issued in CA
Legal business name
SHENG H. CHANG, M.D., INC.
Practice address
330 W Las Tunas Dr
Suite 3
San Gabriel, CA 91776-1213
Phone
(626) 573-0055
Fax
(626) 573-4087
NPI assigned
Jan 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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

Authorized official

Name
Sheng H. Chang, M.D.NPI 1871589903
Title
President
Phone
(626) 573-0055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X A 33409 CA Primary

Addresses

Primary practice location

330 W Las Tunas Dr
Suite 3
San Gabriel, CA 91776-1213

Mailing address

330 W Las Tunas Dr
Suite 3
San Gabriel, CA 91776-1213
Phone (626) 573-0055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100319000605 CA Part B Supplier - Clinic/Group Practice 8426183112 Receives reassigned benefits from 1 practitioner
Practice locations: San Gabriel, CA

National Provider Directory

National Provider Directory

Locations

330 W Las Tunas Dr
#3
San Gabriel, CA 91776
Phone (585) 354-3632

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": "1264636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264636800000",
    "number": "1679804728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W LAS TUNAS DR",
            "address_2": "SUITE 3",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761213",
            "telephone_number": "626-573-0055",
            "fax_number": "626-573-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W LAS TUNAS DR",
            "address_2": "SUITE 3",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761213",
            "telephone_number": "626-573-0055",
            "fax_number": "626-573-4087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENG H. CHANG, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-28",
        "last_updated": "2010-01-28",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "SHENG",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-573-0055",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A 33409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; 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.