MEDICARE: DR. BLISS JEUN CHANG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	35.148057	OH

General Provider Information

NPI Number	:	1174142293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BLISS JEUN CHANG MD

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE # JJ24
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:	216-444-2200
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE # JJ24
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-3733
Country	:	US
Telephone Number	:	216-444-2200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2020
Last Update Date	:	06/02/2026

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