David Sea Jong Chang, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A179367 Issued in CA

Practice address

91275 66TH Street
Suite 500
Mecca, CA 92254

Phone

(760) 396-1249

Fax

(760) 396-1253

NPI assigned

Jun 10, 2019

Last updated

Nov 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Clinicas de Salud del Pueblo IncGroup PAC ID 5496657082, 42 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

98.25 of 100Reported as group

Quality

100

Promoting interoperability

73

Improvement activities

40

Cost

100

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.chang.p1@direct.cdsdp.nextgenshare.com

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.

• Clinicas de Salud del Pueblo, Inc

  dba Innercare

  • Federally Qualified Health Center (FQHC)
  • El Centro, CA
  • NPI 1346313889
  Medicare reassignment Care Compare group NPD
• Innovative Extensivist Group PC

  • Internal Medicine Physician
  • Temecula, CA
  • NPI 1770467888
  Medicare reassignment
• Innovative Medical Group

  dba Innovative Medical Group Temecula

  • Internal Medicine Physician
  • Temecula, CA
  • NPI 1003407735
  Medicare reassignment
• Clinicas de Salud del Pueblo Inc.

  dba InnerCare Pharmacy

  • Community/Retail Pharmacy
  • El Centro, CA
  • NPI 1962045872
  NPD
• Clinicas de Salud del Pueblo, Inc

  dba Innercare

  • Federally Qualified Health Center (FQHC)
  • Mecca, CA
  • NPI 1023188687
  NPD
• Clinicas de Salud del Pueblo, Inc.

  dba Innercare

  • Federally Qualified Health Center (FQHC)
  • Winterhaven, CA
  • NPI 1124109202
  NPD (past)

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1740849066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "852 E DANENBERG DR",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922438517",
            "telephone_number": "760-344-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91275 66TH STREET",
            "address_2": "SUITE 500",
            "city": "MECCA",
            "state": "CA",
            "postal_code": "92254",
            "telephone_number": "760-396-1249",
            "fax_number": "760-396-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "DAVID SEA JONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-10",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A179367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amis Pharmacy Corporation (Mecca Community Pharmacy)
• Jocelyn Avila-Bustos
• Kevin William Canedy, PHYSICIAN ASSISTANT
• Clinicas de Salud del Pueblo Inc (Innercare)
• Clinicas de Salud del Pueblo Inc (Innercare)
• Clinicas de Salud del Pueblo, Inc (Innercare)
• Clinicas de Salud del Pueblo, Inc (Innercare)
• Clinicas de Salud del Pueblo, Inc. (Mecca Health Clinic)

• Family Medicine Physician in Mecca, CA
• Providers in Mecca, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.