Individual provider Active NPI

Henry Chang, D.O.

  • Internal Medicine Physician
  • West Covina, CA
National Provider Identifier
1740430289
Registry record updated Nov 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A10516 Issued in CA
Practice address
2707 E Valley Blvd
Suite 208
West Covina, CA 91792-3195
Phone
(626) 581-0486
Fax
(626) 581-0161
NPI assigned
Sep 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A10516 CA Primary

Addresses

Primary practice location

2707 E Valley Blvd
Suite 208
West Covina, CA 91792-3195

Mailing address

2707 E Valley Blvd
Suite 208
West Covina, CA 91792-3195
Phone (626) 581-0486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100518000490 CA Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 0143359844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Osteopathic Manipulative Medicine
Education
Western University of Health Sciences College of Dental Med, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2707 E Valley Blvd
Suite 208
West Covina, CA 91792-3197
Phone (626) 581-0486

Hospital & facility affiliations

  • Happy Home Health Services Home health agency, Arcadia, CA, CCN 059173
  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
10516CAMDOptometrist
20A10516CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Star Health Medical, Professional Corporation Internal Medicine CurrentSince Nov 22, 2008 Accepting new patients
CHLB, LLC PastSince Feb 1, 2010 Accepting new patients

Locations

2707 E Valley Blvd
Ste 208
West Covina, CA 91792
Phone (626) 258-9348

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: starhealthmedical@shm.directbygreenway.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1221955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290211200000",
    "number": "1740430289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 E VALLEY BLVD",
            "address_2": "SUITE 208",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917923195",
            "telephone_number": "626-581-0486",
            "fax_number": "626-581-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 E VALLEY BLVD",
            "address_2": "SUITE 208",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917923195",
            "telephone_number": "626-581-0486",
            "fax_number": "626-581-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-21",
        "last_updated": "2010-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A10516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.