DR. JACQUELINE A. CHANG (NPI# 1053410027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053410027 |
| Entity Type | Individual |
| Full Name | DR. JACQUELINE A. CHANG |
| Credential | M.D. |
| Practice Address |
9898 Genesee Ave # Amp615 La Jolla CA 92037-1205 |
| Practice Telephone | (858) 824-5404 |
| Practice Fax Number | 8589643129 |
| Mailing Telephone | (858) 824-5404 |
| Mailing Fax Number | 8589643129 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2017-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
G80136 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G801360 | 05 | |
| CHAMPUS | F569 | 01 | |
| RAILROAD MEDICARE | 110180430 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366858045 | Jacqueline Chang | Optometrist | 159 Court St, Brooklyn, NY 11201-4343 | 2014-07-02 |
| 1437785458 | Jacqueline Pei Chia Chang | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-03-21 |
| 1003929696 | Jacqueline C'yen Chang | Internal Medicine | 330 Brookline Ave, Kierstein B23, Boston, MA 02215-5400 | 2006-08-16 |
| Street Address |
9898 GENESEE AVE # AMP615 |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037-1205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
| 1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
| 1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
| 1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
| 1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
| 1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
| 1700357936 | Cecelia Rose Greene/pendzich | Mastectomy Fitter | 7760 Fay Ave, Suite M., La Jolla, CA 92037 | 2018-12-16 |
| 1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
| 1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| Find all providers in zip 92037 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932405081 | Clinton Gilbert Colaco | Internal Medicine | 10666 N Torrey Pines Rd # 207w, La Jolla, CA 92037 | 2011-02-08 |
| 1538491618 | Robert Frank Sarlin | Internal Medicine | 2887 Via Posada, La Jolla, CA 92037-2205 | 2010-02-01 |
| 1265789960 | Nancy Hsu | Internal Medicine | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2012-08-13 |
| 1427322197 | Nicholas Huynh | Internal Medicine | 9300 Campus Point Dr # 7381, La Jolla, CA 92037-1300 | 2012-02-28 |
| 1356480347 | Joseph Mizzell IIi | Internal Medicine | 9850 Genesee Ave, Suite 780, La Jolla, CA 92037-1224 | 2007-02-06 |
| 1295823680 | Carl Ellison Fricks | Internal Medicine | 9850 Genesee Ave, Suite 780, La Jolla, CA 92037-1224 | 2006-10-11 |
| 1528167558 | Darlene J. Elias | Internal Medicine | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2006-09-22 |
| 1699874644 | Stephen P. Bradley | Internal Medicine | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2006-09-22 |
| 1023118098 | Shazia M. Jamil | Internal Medicine | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2006-09-22 |
| 1598777336 | Lalaine Manlutac Corate | Internal Medicine | 9850 Genesee Ave, Suite 780, La Jolla, CA 92037-1224 | 2006-08-12 |
| Find all providers in LA JOLLA | ||||
Please comment or provide details below to improve the information on DR. JACQUELINE A. CHANG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.