Marisa Chang MD Incorporated

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A93323 Issued in CA

Legal business name

MARISA CHANG MD INCORPORATED

Practice address

2811 Wilshire Blvd
Suite 790
Santa Monica, CA 90403-4803

Phone

(323) 829-5968

Fax

(310) 453-3685

NPI assigned

Jan 23, 2009

Last updated

Mar 19, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marisa Chang, M.D.

Title

Owner

Phone

(323) 633-1420

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237420800000",
    "number": "1942448253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "SUITE 790",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034803",
            "telephone_number": "323-829-5968",
            "fax_number": "310-453-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "SUITE 790",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034803",
            "telephone_number": "323-829-5968",
            "fax_number": "310-453-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARISA CHANG MD INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-23",
        "last_updated": "2009-03-19",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "MARISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-633-1420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A93323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; 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.