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General NPI Number Information
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NPI Number | 1750692448
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Entity Type | Individual
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Provider Name | JAMIE DER JOON CHANG M.D., M.B.A
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Gender | Male
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Dates
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Enumeration Date | 06/28/2010
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 6041 CADILLAC AVENUE KAISER WEST LA MEDICAL CENTER, EMERGENCY DEPARTMENT
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City | LOS ANGELES
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State | CA
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Zip | 90034-1702
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Country | US
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Telephone | 323-857-3161
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Fax |
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Provider Business Mailing Address
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Address Line | 6041 CADILLAC AVENUE KAISER WEST LA MEDICAL CENTER, EMERGENCY DEPARTMENT
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City | LOS ANGELES
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State | CA
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Zip | 90034-1702
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A117678
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License Number State | CA
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