Individual provider Active NPI

Lawrence W Chang, OD

  • Optometrist
  • Pasadena, CA
National Provider Identifier
1750473344
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8207T Issued in CA
Practice address
477 E Colorado Blvd
Pasadena, CA 91101
Phone
(626) 796-1191
Fax
(626) 796-0189
NPI assigned
Sep 29, 2006
Last updated
Mar 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8207T CA Primary

Addresses

Primary practice location

477 E Colorado Blvd
Pasadena, CA 91101

Mailing address

PO Box 3622
South Pasadena, CA 91031-6622
Phone (626) 799-6968

Other identifiers 1

IdentifierTypeStateIssuer
SD0082070MedicaidCA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040325001805 CA Practitioner - Optometry 6800788704 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8207TCAMDOptometrist
8207CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Linden Optometry a Professional Corporation Optometrist CurrentSince May 1, 2003 Accepting new patients

Locations

477 E Colorado Blvd
Pasadena, CA 91101
Phone (626) 796-1191

Organizations & group practices 1

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1750473344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3622",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910316622",
            "telephone_number": "626-799-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 E COLORADO BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91101",
            "telephone_number": "626-796-1191",
            "fax_number": "626-796-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "LAWRENCE",
        "middle_name": "W",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8207T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0082070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.