Healthcare Provider Details

I. General information

NPI: 1336074772
Provider Name (Legal Business Name): MS. RACHEL CHANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 S HUDSON AVE APT 7
PASADENA CA
91101-2984
US

IV. Provider business mailing address

215 S HUDSON AVE APT 7
PASADENA CA
91101-2984
US

V. Phone/Fax

Practice location:
  • Phone: 310-908-8082
  • Fax:
Mailing address:
  • Phone: 310-908-8082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: