Shady Canyon Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A77997 Issued in CA

Legal business name

SHADY CANYON MEDICAL GROUP

Practice address

15825 Laguna Canyon Rd Ste 104
Irvine, CA 92618-2126

Phone

(949) 585-9870

Fax

(949) 585-9331

NPI assigned

Jan 8, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Albert Beomjin Chang, M.D.NPI 1790755569

Title

MD/Owner

Phone

(949) 585-9870

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Albert Beomjin Chang, M.D.

  • Family Medicine Physician
  • Irvine, CA
  • NPI 1790755569
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766016000000",
    "number": "1922245349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15825 LAGUNA CANYON RD STE 104",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182126",
            "telephone_number": "949-585-9870",
            "fax_number": "949-585-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15825 LAGUNA CANYON RD STE 104",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182126",
            "telephone_number": "949-585-9870",
            "fax_number": "949-585-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY CANYON MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "BEOMJIN",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "949-585-9870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A77997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Robert Sexton, M.D.
• James Aaron Sexton
• Aubree Deme Seybert
• Mir J Shadjareh, D.C.
• Shadow Management Services, Inc.
• Parvin Shafa, M.D.
• Samira Shafaee, DDS
• James Thomas Shafer, PH.D.
• Leora Shaffer, MA CCC-SLP
• Mitchell Shaffer, LMFTPH.D.

• Family Medicine Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.