Healthcare Provider Details

I. General information

NPI: 1366465304
Provider Name (Legal Business Name): JOHNNY K CHANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18133 VENTURA BLVD STE 300
TARZANA CA
91356-3645
US

IV. Provider business mailing address

18133 VENTURA BLVD #300
ENCINO CA
91536
US

V. Phone/Fax

Practice location:
  • Phone: 818-981-3818
  • Fax: 818-784-3106
Mailing address:
  • Phone: 818-981-3818
  • Fax: 818-784-3106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA70618
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: