Healthcare Provider Details

I. General information

NPI: 1861427643
Provider Name (Legal Business Name): DONALD STEVEN CHANG MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 02/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UCLA 200 MEDICAL PLAZA SUITE #365
LOS ANGELES CA
90095
US

IV. Provider business mailing address

11301 WILSHIRE BLVD # 111E ROOM 4425
LOS ANGELES CA
90073-1003
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-0631
  • Fax: 310-206-3607
Mailing address:
  • Phone: 310-268-3643
  • Fax: 310-268-4288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG77688
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG77688
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: