MEDICARE: DR. STEVEN Y CHANG MD, PHD

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	25MA08089400	NJ
2	207RP1001X	Pulmonary Disease Physician	25MA08089400	NJ
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	G89398	CA
4	207RP1001X	Pulmonary Disease Physician	G89398	CA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376515023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN Y CHANG MD, PHD

Provider Business Mailing Address
First Line	:	10833 LE CONTE AVE RM 37-131
Second Line	:	PULMONARY & CRITICAL CARE MEDICINE
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-1690
Country	:	US
Telephone Number	:	310-825-5316
Fax Number	:	310-206-8622

Provider Business Practice Location Address
First Line	:	150 BERGEN ST # UH I-354
Second Line	:	UMDNJ - MICU DIRECTOR
City	:	NEWARK
State	:	NJ
Zip	:	07103-2496
Country	:	US
Telephone Number	:	973-972-6111
Fax Number	:	973-972-6228

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

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	01/13/2015

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