Healthcare Provider Details

I. General information

NPI: 1730576687
Provider Name (Legal Business Name): TRACY YUN-SHIN CHANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6260 SIMPSON AVE
NORTH HOLLYWOOD CA
91606-3416
US

IV. Provider business mailing address

6260 SIMPSON AVE
NORTH HOLLYWOOD CA
91606-3416
US

V. Phone/Fax

Practice location:
  • Phone: 818-821-4996
  • Fax:
Mailing address:
  • Phone: 818-821-4996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number171842
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: