Active NPI
Marisa Corinne Chang, MD
- Neurology Physician
- Santa Monica, CA
National Provider Identifier
1730348269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- A93323
- Practice address
- 2730 Wilshire Blvd Ste 320
Santa Monica, CA 90403 - Phone
- (310) 382-1150
- Fax
- (310) 382-1153
- NPI assigned
- Jun 9, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | A93323 | CA | Primary |
Addresses
Primary practice location
2730 Wilshire Blvd Ste 320
Santa Monica, CA 90403
Mailing address
2730 Wilshire Blvd Ste 320
Santa Monica, CA 90403
Phone (310) 382-1150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A93323 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2012 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63323 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784073600000",
"number": "1730348269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2730 WILSHIRE BLVD STE 320",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "90403",
"telephone_number": "310-382-1150",
"fax_number": "310-382-1153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2730 WILSHIRE BLVD STE 320",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "90403",
"telephone_number": "310-382-1150",
"fax_number": "310-382-1153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "MARISA",
"middle_name": "CORINNE",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-09",
"last_updated": "2026-07-15",
"certification_date": "2026-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CA",
"license": "A93323",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A93323",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.