Individual provider Active NPI

Doris Tehkwang Chang, O.D.

  • Optometrist
  • Antioch, CA
National Provider Identifier
1720120769
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12522T Issued in CA
Practice address
4051 Lone Tree Way
Suite E
Antioch, CA 94531-6204
Phone
(925) 757-7676
Fax
(925) 757-0652
NPI assigned
Feb 13, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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
Optometrist 152W00000X 12522T CA Primary

Addresses

Primary practice location

4051 Lone Tree Way
Suite E
Antioch, CA 94531-6204

Mailing address

4051 Lone Tree Way
Suite E
Antioch, CA 94531-6204
Phone (925) 757-7676

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

State licenses

LicenseStateTypeSpecialty
12522TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eileen M Linder Optometrist Inc Optometrist PastSince Jun 18, 2008 Accepting new patients
Dr. Melanie N. Feliciano - Optometry Inc. Optometrist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720120769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4051 LONE TREE WAY",
            "address_2": "SUITE E",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945316204",
            "telephone_number": "925-757-7676",
            "fax_number": "925-757-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 LONE TREE WAY",
            "address_2": "SUITE E",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945316204",
            "telephone_number": "925-757-7676",
            "fax_number": "925-757-0652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "DORIS",
        "middle_name": "TEHKWANG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12522T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, 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.