Healthcare Provider Details

I. General information

NPI: 1194401422
Provider Name (Legal Business Name): RYAN CHANG, DPM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 09/02/2025
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 CORPORATE PARK STE 235
IRVINE CA
92606-3123
US

IV. Provider business mailing address

46 SNAPDRAGON
IRVINE CA
92604-2844
US

V. Phone/Fax

Practice location:
  • Phone: 949-484-4405
  • Fax: 949-368-2230
Mailing address:
  • Phone: 201-981-3166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. WON HO CHANG
Title or Position: CEO
Credential: DPM
Phone: 949-484-4405