Individual provider Active NPI

Roxanne Sui Tze Pan Chang, MD

  • Pediatrics Physician
  • Torrance, CA
National Provider Identifier
1780623389
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A78427 Issued in CA
Practice address
21081 S Western Ave
Suite 295
Torrance, CA 90501-1703
Phone
(310) 533-6600
NPI assigned
Jun 6, 2006
Last updated
Jul 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00044102 WA
Pediatrics Physician 208000000X A78427 CA Primary

Addresses

Primary practice location

21081 S Western Ave
Suite 295
Torrance, CA 90501-1703

Mailing address

21081 S Western Ave
Suite 295
Torrance, CA 90501-1703
Phone (310) 533-6600

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
I20120517000674 CA Practitioner - Pediatric Medicine 6800838970 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78427CAMDPharmacist
A78427CAMDPediatrics Physician
MD00044102WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Mar 24, 2012 Accepting new patients
County of Los Angeles CurrentSince Mar 24, 2012 Accepting new patients
Public Hospital District No 4, King County Wa Pediatrics Past Accepting new patients
Los Angeles County Department of Mental Health Past Accepting new patients
Public Hospital District No. 4, King County Washington Pediatrics Past Accepting new patients
Pacific Palisades Podiatry PLLC Past Accepting new patients
Public Hospital District No 4 King County Washington Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

Organizations & group practices 7

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1780623389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21081 S WESTERN AVE",
            "address_2": "SUITE 295",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905011703",
            "telephone_number": "310-533-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21081 S WESTERN AVE",
            "address_2": "SUITE 295",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905011703",
            "telephone_number": "310-533-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "ROXANNE",
        "middle_name": "SUI TZE PAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00044102",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A78427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.