MEDICARE: KERI CHANG MAR NP

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	363LF0000X	Family Nurse Practitioner	95037409	CA

General Provider Information

NPI Number	:	1750247557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERI CHANG MAR NP

Provider Business Mailing Address
First Line	:	215 W NAOMI AVE
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91007-6912
Country	:	US
Telephone Number	:	626-379-6226
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 W NAOMI AVE
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91007-6912
Country	:	US
Telephone Number	:	626-379-6226
Fax Number	:

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

Provider Enumeration Date	:	12/25/2025
Last Update Date	:	12/25/2025

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Directions to “ KERI CHANG MAR NP” Practice Location

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