DR. JAE KI CHANG (NPI# 1831320977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831320977 |
| Entity Type | Individual |
| Full Name | DR. JAE KI CHANG |
| Credential | PHARM.D. |
| Practice Address |
211 Pueblo Way Vallejo CA 94591-8220 |
| Practice Telephone | 5108696792 |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
54105 | CA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124426663 | Jae Chang | Pharmacist | 6017 Forest View Rd Apt 3d, Lisle, IL 60532-3370 | 2014-12-16 |
| 1124387287 | Jae Yong Chang | Acupuncturist | 579 Bergen Blvd Fl 2, Ridgefield, NJ 07657-2032 | 2012-05-10 |
| 1528258704 | Jae Kyung Chang | Chiropractor | 1240 116th Ave Ne, 101, Bellevue, WA 98004-3815 | 2007-07-25 |
| Street Address |
211 PUEBLO WAY |
| City | VALLEJO |
| State | CA |
| Zip Code | 94591-8220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497356901 | Andrew Garcia | Behavior Technician | 150 Glen Gove Marina Rd., #102, Vallejo, CA 94591 | 2020-11-03 |
| 1396353504 | Marlesia Marvae Gonzales | Behavior Technician | 150 Glen Cove Marina Rd., #102, Vallejo, CA 94591 | 2020-07-14 |
| 1033741061 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 910 Admiral Callaghan Lane, Vallejo, CA 94591 | 2020-02-07 |
| 1639633860 | Angelo Duaso | Respiratory Therapist, Certified | 712 North Regatta Drive, Vallejo, CA 94591 | 2019-01-22 |
| 1467923615 | Maria Perez | Behavioral Analyst | 150 Glen Code Marina Rd #102, Vallejo, CA 94591 | 2018-12-16 |
| 1285119966 | Josie Gerber | Registered Nurse | 9268 Hallmark Place, Vallejo, CA 94591 | 2018-09-28 |
| 1912491911 | Lamigo LLC | Optometrist | 121 Plaza Dr Ste 505, Vallejo, CA 94591 | 2018-06-22 |
| 1942655055 | Brisbain Rigor Pucan | Dentist | 2143 Springs Rd, #51, Vallejo, CA 94591 | 2016-04-26 |
| 1811323066 | Bianca Tayne Payne | Counselor | 408 Tennesse St, Vallejo, CA 94591 | 2013-09-19 |
| 1285973602 | Kushwantjit Singh Randhawa | Dentist | 300 Hillary Way Apt 91, Vallejo, CA 94591 | 2013-02-05 |
| Find all providers in zip 94591 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194034710 | Paul Robert Hansen | Pharmacist | 1310 Johnson Lane, Mare Island, Vallejo, CA 94592 | 2010-09-30 |
| 1578051082 | Liuqing Yang | Pharmacist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2018-04-30 |
| 1033586151 | Hieu Minh Phan | Pharmacist | 300 Hospital Dr, Vallejo, CA 94589-2574 | 2015-08-24 |
| 1164802617 | Clipper Young | Pharmacist | 365 Tuolumne St, Vallejo, CA 94590-5700 | 2015-05-30 |
| 1578964136 | Amanda Que-anh La | Pharmacist | 525 Oregon St, Vallejo, CA 94590-3201 | 2014-09-12 |
| 1891041901 | Jelyn Evangelista | Pharmacist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2012-07-25 |
| 1134455041 | Rebecca Fullarton | Pharmacist | 975 Sereno Dr, Department of Pharmacy, Ambulatory Care, Vallejo, CA 94589-2441 | 2009-10-27 |
| 1649431362 | Sharlene Gayle Dwinell | Pharmacist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2008-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376142430 | Daria Mohazzab Hosseinian | Pharmacist | 450 E Spring St Ste 11, Long Beach, CA 90806-1625 | 2020-10-20 |
| 1235745100 | Ngoc Tran | Pharmacist | 10371 Luders Ave, Garden Grove, CA 92843-3213 | 2020-09-16 |
| 1275143752 | Sherine Ann Legge | Pharmacist | 17 Westchester Ct, Trabuco Canyon, CA 92679-4955 | 2020-08-09 |
| 1922618412 | Ashley Keane Hayes | Pharmacist | 6551 E El Pulcro St, Long Beach, CA 90815-2302 | 2020-08-09 |
| 1750991543 | Priyankumar Arvind Patel | Pharmacist | 2339 S G St, Fresno, CA 93721-3425 | 2020-08-05 |
| 1912521261 | Sharon Jung | Pharmacist | 851 Langholm Way, Riverside, CA 92508-6075 | 2020-06-02 |
| 1710500376 | Christine Nguyen | Pharmacist | 2248 E Nyon Ave, Anaheim, CA 92806-4634 | 2020-05-18 |
| 1134740582 | Cj3m Corporation | Pharmacist | 2626 El Camino Real Ste A, Carlsbad, CA 92008-1253 | 2020-04-27 |
| 1629607775 | Tiffany Chang | Pharmacist | 213 Quarry Rd Rm 2726a, Palo Alto, CA 94304-1416 | 2020-04-01 |
| 1124655782 | Noor Mikhail | Pharmacist | 220 W Main St Ste 102, El Cajon, CA 92020-3462 | 2020-03-24 |
| Find all providers with the same taxonomy | ||||
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| 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.