Organization Active NPI

Lisa Chang Medical Corporation

  • Obstetrics & Gynecology Physician
  • Pasadena, CA
National Provider Identifier
1952656613
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A12080 Issued in CA
Legal business name
LISA CHANG MEDICAL CORPORATION
Practice address
50 Alessandro PL Ste 430
Pasadena, CA 91105-3170
Phone
(626) 208-3988
Fax
(626) 210-2626
NPI assigned
Jul 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Authorized official

Name
Lisa Chang, DONPI 1437314218
Title
Ceo
Phone
(626) 208-3988

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 20A12080 CA Primary

Addresses

Primary practice location

50 Alessandro PL Ste 430
Pasadena, CA 91105-3170

Mailing address

288 E Live Oak Ave a#128
Arcadia, CA 91006-5665
Phone (626) 208-3988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130124000289 CA Part B Supplier - Clinic/Group Practice 5991959082 Receives reassigned benefits from 1 practitioner
Practice locations: Pasadena, CA

National Provider Directory

National Provider Directory

Locations

288 E Live Oak Ave
Ste A128
Arcadia, CA 91006

288 E Live Oak Ave
#A128
Arcadia, CA 91006

1671 S Azusa Ave
Hacienda Heights, CA 91745

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763078400000",
    "number": "1952656613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 E LIVE OAK AVE A#128",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910065665",
            "telephone_number": "626-208-3988",
            "fax_number": "626-210-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ALESSANDRO PL STE 430",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053170",
            "telephone_number": "626-208-3988",
            "fax_number": "626-210-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA CHANG MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-208-3988",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A12080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.