Active NPI
Edward Chang
- Pharmacist
- Rocklin, CA
National Provider Identifier
1972167047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 79513
- Practice address
- 4785 Granite Dr
Rocklin, CA 95677-2853 - Phone
- (916) 624-8286
- NPI assigned
- Apr 24, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 79513 | CA | Primary |
Addresses
Primary practice location
4785 Granite Dr
Rocklin, CA 95677-2853
Mailing address
4785 Granite Dr
Rocklin, CA 95677-2853
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79513 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California LLC | Past | Accepting new patients | |
| Longs Drug Store California LLC | Past | 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 and National Provider Directory roles.
-
- Pharmacy
- Rocklin, CA
- NPI 1407899297
-
- Pharmacy
- Kapolei, HI
- NPI 1700565793
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1972167047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4785 GRANITE DR",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "956772853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4785 GRANITE DR",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "956772853",
"telephone_number": "916-624-8286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "EDWARD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-24",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "CA",
"license": "79513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rocklin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.