Individual provider Active NPI

Sammy L. Chang, M.D.

  • Pediatrics Physician
  • Sacramento, CA
National Provider Identifier
1710993969
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G38900 Issued in CA
Practice address
3160 Folsom Blvd
Sacramento, CA 95816-5219
Phone
(916) 733-5336
Fax
(916) 733-5385
NPI assigned
Jul 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G38900 CA Primary

Addresses

Primary practice location

3160 Folsom Blvd
Sacramento, CA 95816-5219

Mailing address

5 Cobblelake CT
Sacramento, CA 95831-4319

Other identifiers 14

IdentifierTypeStateIssuer
799901OtherCAUNITED
MCMG123900OtherCAWESTERN HEALTH ADVANTAGE
00G389000MedicaidCA
4136OtherCAINTERPLAN
4467996OtherCAAETNA
1089809OtherCAGREAT WEST
502629OtherCAHEALTH NET
G38900OtherCABLU CROSS
1061826OtherCAFIRST HEALTH
2183696OtherCAFIRST HEALTH
00G389000OtherCABLUE SHIELD
3794938OtherCACIGNA
90026119OtherCAPACIFICARE
00081342555OtherCAPHCS

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G38900CAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710993969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 COBBLELAKE CT",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958314319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 FOLSOM BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165219",
            "telephone_number": "916-733-5336",
            "fax_number": "916-733-5385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "SAMMY",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G38900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "799901",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WESTERN HEALTH ADVANTAGE",
            "identifier": "MCMG123900",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G389000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERPLAN",
            "identifier": "4136",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4467996",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "1089809",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "502629",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLU CROSS",
            "identifier": "G38900",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1061826",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2183696",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G389000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3794938",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE",
            "identifier": "90026119",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "00081342555",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.