Individual provider Active NPI

Miri Park Chang, FNP-BC

  • Family Nurse Practitioner
  • Downey, CA
National Provider Identifier
1851610158
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP 19603 Issued in CA
Practice address
10000 Lakewood Blvd
Downey, CA 90240-4020
Phone
(562) 862-3684
NPI assigned
May 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP 19603 CA Primary
Family Nurse Practitioner 363LF0000X APRN 1230 HI

Addresses

Primary practice location

10000 Lakewood Blvd
Downey, CA 90240-4020

Mailing address

10000 Lakewood Blvd
Downey, CA 90240-4020
Phone (562) 862-3684

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210826003279 CA Practitioner - Nurse Practitioner 0941431142 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NP 19603CAMDFamily Nurse Practitioner
APRN 1230HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albion Medical Partners of California West P C CurrentSince Jul 17, 2021 Accepting new patients

Locations

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

Interoperability endpoints

  • Direct secure messaging: miri.chang.p1@direct.caremorewest.nextgenshare.com
  • Direct secure messaging: miri.chang.1@32527.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1851610158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 LAKEWOOD BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902404020",
            "telephone_number": "562-862-3684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 LAKEWOOD BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902404020",
            "telephone_number": "562-862-3684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "MIRI",
        "middle_name": "PARK",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-26",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP 19603",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN 1230",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.