MEDICARE: RICHARD S. CHANG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A73466	CA
2	2085R0202X	Diagnostic Radiology Physician	A73466	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00784478	OTHER	CA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	00A734660	OTHER	CA	MEDI-CAL
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154384311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD S. CHANG M.D.

Provider Business Mailing Address
First Line	:	13236 N 7TH ST STE 4
Second Line	:	#504
City	:	PHOENIX
State	:	AZ
Zip	:	85022-5343
Country	:	US
Telephone Number	:	623-296-2149
Fax Number	:

Provider Business Practice Location Address
First Line	:	344 18TH ST
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90402-2406
Country	:	US
Telephone Number	:	310-260-8581
Fax Number	:	888-960-2154

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	03/14/2025

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Directions to “ RICHARD S. CHANG M.D.” Practice Location

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