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General NPI Number Information
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NPI Number | 1861275497
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Entity Type | Organization
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Legal Business Name | CALIFORNIA PPO LLC
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Dates
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Enumeration Date | 08/16/2023
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 23901 CALABASAS RD STE 2080
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City | CALABASAS
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State | CA
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Zip | 91302-4104
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Country | US
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Telephone | 310-954-6454
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Fax |
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Provider Business Mailing Address
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Address Line | 22287 MULHOLLAND HWY # 526
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City | CALABASAS
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State | CA
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Zip | 91302-5157
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Country | US
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Telephone | 877-772-8071
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Fax | 877-261-7383
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | LYNN CHANG
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Credential | DO
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Telephone | 877-772-7081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202C00000X
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Taxonomy Name | Independent Medical Examiner Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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