Individual provider Active NPI

Terrance T Chang

  • Allergy & Immunology Physician
  • Roseville, CA
National Provider Identifier
1861561219
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
G33580 Issued in CA
Practice address
8723 Sierra College Blvd
Suite 220
Roseville, CA 95661-5920
Phone
(916) 791-0797
Fax
(916) 791-1479
NPI assigned
Nov 7, 2006
Last updated
Mar 3, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X G33580 CA Primary
Allergy Physician 207KA0200X G33580 CA
Clinical & Laboratory Immunology (Allergy & Immunology) Physician 207KI0005X G33580 CA
Pediatrics Physician 208000000X G33580 CA
Pediatric Clinical & Laboratory Immunology Physician 2080I0007X G33580 CA
Developmental - Behavioral Pediatrics Physician 2080P0006X G33580 CA
Pediatric Allergy/Immunology Physician 2080P0201X G33580 CA

Addresses

Primary practice location

8723 Sierra College Blvd
Suite 220
Roseville, CA 95661-5920

Mailing address

4120 Douglas Blvd
# 112
Granite Bay, CA 95746-5936
Phone (916) 791-0797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33580CAMDLicensed Psychiatric Technician
G33580CAMDClinical & Laboratory Immunology (Allergy & Immunology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Berman Skin Institute Medical Group Inc PastSince Jul 20, 2016 Accepting new patients

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, 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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1861561219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 DOUGLAS BLVD",
            "address_2": "# 112",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957465936",
            "telephone_number": "916-791-0797",
            "fax_number": "916-791-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8723 SIERRA COLLEGE BLVD",
            "address_2": "SUITE 220",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615920",
            "telephone_number": "916-791-0797",
            "fax_number": "916-791-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "TERRANCE",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "G33580",
            "primary": true
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "G33580",
            "primary": false
        },
        {
            "code": "207KI0005X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
            "state": "CA",
            "license": "G33580",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G33580",
            "primary": false
        },
        {
            "code": "2080I0007X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Clinical & Laboratory Immunology",
            "state": "CA",
            "license": "G33580",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "CA",
            "license": "G33580",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "CA",
            "license": "G33580",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.