CHANG, JAMES OWEN (MD)

Provider Demographics

• NPI: 1366629966
• Name: CHANG, JAMES OWEN (MD)
• Entity Type: Individual
• First Name: JAMES
• Middle Name: OWEN
• Last Name: CHANG
• Gender: M
• Credentials: MD
• Mailing Address - Street 1: 10800 E GEDDES AVE STE 300
• Mailing Address - City: ENGLEWOOD
• Mailing Address - State: CO
• Mailing Address - Zip Code: 80112-3895
• Mailing Address - Country: US
• Mailing Address - Phone: 303-761-9190
• Mailing Address - Fax: 720-874-4462
• Practice Address - Street 1: 10800 E GEDDES AVE STE 300
• Practice Address - City: ENGLEWOOD
• Practice Address - State: CO
• Practice Address - Zip Code: 80112-3895
• Practice Address - Country: US
• Practice Address - Phone: 303-761-9190
• Practice Address - Fax: 720-874-4462
• Is Sole Proprietor?: No
• Enumeration Date: 2008-01-25
• Last Update Date: 2022-12-09

Provider Licenses

State	License ID	Taxonomies
NE	27400	2085R0202X
KS	04-36650	2085R0202X
TX	R1716	2085R0202X
HI	MD17587	2085R0202X
TN	54090	2085R0202X
WI		390200000X
CO	52316	2085R0202X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology
No	390200000X	Student, Health Care	Student in an Organized Health Care Education/Training Program

Provider Identifiers

State	Identifier ID	ID Type	Issuer
MT	1366629966	Medicaid
NE	10025709000	Medicaid
WY	1366629966	Medicaid
NE	84089712600	Medicaid
NE	10026277600	Medicaid
KS	201084950A	Medicaid
AZ	853401	Medicaid
NM	87709341	Medicaid
NE	10026277300	Medicaid
NE	10026277400	Medicaid
NE	10026277500	Medicaid
NE	10026277800	Medicaid
UT	1366629966	Medicaid
OK	200510320A	Medicaid
CO	53273052	Medicaid
NE	10026277700	Medicaid
NE	84059792913	Medicaid
NE	10026277800	Medicaid
KS	201084950A	Medicaid
CO	P01232838	Medicare PIN
HI	H106301	Medicare PIN
CO	301087YQPG	Medicare PIN
CO	301087YQN9	Medicare PIN
NE	84089712600	Medicaid
CO	53273052	Medicaid
AZ	853401	Medicaid
NE	84059792913	Medicaid
CO	301087ZLJ3	Medicare PIN
KS	111257052	Medicare PIN