SEUNGKOOK CHANG MD INC (NPI# 1679874309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679874309 |
| Entity Type | Organization |
| Organization Name | SEUNGKOOK CHANG MD INC |
| Other Organization Name | WALNUT MEDICAL GROUP |
| Practice Address |
19687 Valley Blvd Walnut CA 91789-2146 |
| Practice Telephone | 9095985228 |
| Practice Fax Number | 9095989021 |
| Mailing Telephone | 9095985228 |
| Mailing Fax Number | 9095989021 |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2010-11-11 |
| Authorized Official Name | SEUNG KOOK CHANG (PRESIDENT) |
| Authorized Official Telephone | 9095985228 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
A35067 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Walnut medical Group | Doing Business As Name - Organization |
| Street Address |
19687 VALLEY BLVD |
| City | WALNUT |
| State | CA |
| Zip Code | 91789-2146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073603460 | Seung Chang | Family Medicine | 19687 Valley Blvd, Walnut, CA 91789-2146 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154964203 | Dolores A. Lopez | Technician | 335 San Roque Drive, Walnut, CA 91789 | 2019-10-22 |
| 1831754233 | Huei-chen Hsu | Pharmacist | 21590 East Valley Blvd., Walnut, CA 91789 | 2019-05-01 |
| 1114486511 | A Plus Acupuncture | Acupuncturist | 1239 N Grand Ave, Walnut, CA 91789 | 2019-03-14 |
| 1003399106 | Larry Besong | Respiratory Therapist, Registered | 22285 Roundup Dr, Walnut, CA 91789 | 2018-09-13 |
| 1114418837 | Yu Yao Lai | Acupuncturist | 20627 Golden Springs Dr # J, Diamond Bar, CA 91789 | 2018-05-29 |
| 1720575608 | Sonam Patel | Pharmacist | 1533 Parker Canyon Road, Walnut, CA 91789 | 2018-04-17 |
| 1649799206 | Jacquelyn Lising | Dietitian, Registered | 911 Summitview Ct, Walnut, CA 91789 | 2017-09-14 |
| 1497272389 | Jennifer Diaz | Behavior Technician | 539 Castlehill Dr, Walnut, CA 91789 | 2017-08-23 |
| 1952759888 | Laurentino Lozada De Guia Jr. | Dentist | 778 Nogales St., Suite G, Walnut, CA 91789 | 2016-06-01 |
| 1679970859 | Grace Park | Chiropractor | 20627 Golden Springs Dr., 2-b, Diamond Bar, CA 91789 | 2014-12-03 |
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| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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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.