Provider Demographics
NPI:1518170083
Name:CHANG, DAVID HAI RU (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:HAI RU
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8536 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3153
Mailing Address - Country:US
Mailing Address - Phone:310-248-8300
Mailing Address - Fax:310-248-8333
Practice Address - Street 1:8536 WILSHIRE BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3153
Practice Address - Country:US
Practice Address - Phone:310-248-8300
Practice Address - Fax:310-248-8333
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84386207R00000X, 207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABJ371YMedicare PIN