Individual provider Active NPI

Lauren Suwen Liang-Chang, OD

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1801474283
Registry record updated Jun 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34855 Issued in CA
Practice address
11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Phone
(808) 393-8938
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 34855 CA Primary

Addresses

Primary practice location

11301 Wilshire Blvd
Los Angeles, CA 90073-1003

Mailing address

301 S Glendora Ave Unit 1201
West Covina, CA 91790-3092
Phone (808) 393-8938

Other practice location 1

4961 Arrow Hwy # 15-308
Montclair, CA 91763-1300
Phone (808) 393-8938

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
I20230104002862 CA Practitioner - Optometry 6507236700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gabriel Jacob MD a Medical CorporationGroup PAC ID 7416196928, 7 clinicians

Practice addresses (Care Compare)

8120 Timberlake Way
Suite 211
Sacramento, CA 95823-5414
Phone (916) 423-2134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34855CAMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Gabriel Jacob MD, a Medical Corporation CurrentSince Jul 1, 2024 Accepting new patients
Paris E. Royo, MD Inc Past Accepting new patients

Locations

2510 Douglas Blvd
Ste 400
Roseville, CA 95661
Phone (916) 423-4477

5404 Laurel Hills Dr
Sacramento, CA 95841
Phone (916) 967-4339

8120 Timberlake Way
Ste 211
Sacramento, CA 95823
Phone (916) 423-2134

8120 Timberlake Way
Sacramento, CA 95823
Phone (408) 998-5551

Interoperability endpoints

  • Direct secure messaging: lliangchang688323@hisp.ehr.sutterhealth.org
  • Direct secure messaging: lliang@californiaeye.intellechartdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654300800000",
    "number": "1801474283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S GLENDORA AVE UNIT 1201",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903092",
            "telephone_number": "808-393-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003",
            "telephone_number": "808-393-8938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4961 Arrow Hwy # 15-308",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "CA",
            "postal_code": "917631300",
            "country_code": "US",
            "telephone_number": "808-393-8938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIANG-CHANG",
        "first_name": "LAUREN",
        "middle_name": "SUWEN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2022-06-04",
        "certification_date": "2022-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.