Healthcare Provider Details

I. General information

NPI: 1386151199
Provider Name (Legal Business Name): INHWAN CHANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2018
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 W OLYMPIC BLVD STE 209
LOS ANGELES CA
90006-2640
US

IV. Provider business mailing address

2727 W OLYMPIC BLVD STE 209
LOS ANGELES CA
90006-2640
US

V. Phone/Fax

Practice location:
  • Phone: 213-408-6284
  • Fax:
Mailing address:
  • Phone: 213-408-6284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA147167
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA147167
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberA147167
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA147167
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: