Healthcare Provider Details

I. General information

NPI: 1437647146
Provider Name (Legal Business Name): MARGUERITE CHANGALA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2018
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 VILLA LA JOLLA DR STE A215
LA JOLLA CA
92037-1711
US

IV. Provider business mailing address

8950 VILLA LA JOLLA DR STE A215
LA JOLLA CA
92037-1711
US

V. Phone/Fax

Practice location:
  • Phone: 619-356-0794
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA164813
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number164813
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA164813
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: