Healthcare Provider Details

I. General information

NPI: 1033842562
Provider Name (Legal Business Name): DR. VINCENT TING WEI CHANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2022
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 S SAN VICENTE BLVD STE A6600
LOS ANGELES CA
90048-3311
US

IV. Provider business mailing address

7304 BEVERLY BLVD # 1008
LOS ANGELES CA
90036-2535
US

V. Phone/Fax

Practice location:
  • Phone: 424-315-4492
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: