Active NPI
Lori Chang
- Registered Dietitian
- Los Angeles, CA
National Provider Identifier
1699208330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 961204
- Practice address
- 5105 W Goldleaf Cir
Los Angeles, CA 90056-1269 - Phone
- (323) 298-3300
- NPI assigned
- Apr 10, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 961204 | CA | Primary |
Addresses
Primary practice location
5105 W Goldleaf Cir
Los Angeles, CA 90056-1269
Mailing address
2012 Clark LN
Unit a
Redondo Beach, CA 90278-4206
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 |
|---|---|---|---|
| 961204 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491782400000",
"number": "1699208330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2012 CLARK LN",
"address_2": "UNIT A",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902784206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5105 W GOLDLEAF CIR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900561269",
"telephone_number": "323-298-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "LORI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-10",
"last_updated": "2017-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "961204",
"primary": true
}
],
"identifiers": [],
"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 Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.