Provider Demographics
NPI:1376515023
Name:CHANG, STEVEN Y (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:Y
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10833 LE CONTE AVE RM 37-131
Mailing Address - Street 2:PULMONARY & CRITICAL CARE MEDICINE
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1690
Mailing Address - Country:US
Mailing Address - Phone:310-825-5316
Mailing Address - Fax:310-206-8622
Practice Address - Street 1:150 BERGEN ST # UH I-354
Practice Address - Street 2:UMDNJ - MICU DIRECTOR
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2496
Practice Address - Country:US
Practice Address - Phone:973-972-6111
Practice Address - Fax:973-972-6228
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08089400207RC0200X, 207RP1001X
CAG89398207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0152021Medicaid
NY02359626Medicaid
NY8R4542Medicare ID - Type Unspecified
NJ0152021Medicaid