Healthcare Provider Details

I. General information

NPI: 1063331361
Provider Name (Legal Business Name): GLORIA J CHANG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 S BREEZY WAY
ORANGE CA
92869-5045
US

IV. Provider business mailing address

525 S BREEZY WAY
ORANGE CA
92869-5045
US

V. Phone/Fax

Practice location:
  • Phone: 949-734-3901
  • Fax:
Mailing address:
  • Phone: 949-734-3901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95028778
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: