Look up the most recent NPI and PECOS records

Brennan Chang

Emergency Medicine

Allopathic & Osteopathic Physicians

4445 Magnolia Ave, Riverside, CA 92501-4135

PECOS Enrollment

Based on the most recent information from CMS, provider Brennan Chang is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1306473343
Provider Type
Individual
Full Name
Chang, Brennan
Gender
Male

Sole Proprietor
No
Enumeration Date
3/26/2020
Last Updated
11/20/2023

Contact Information

Practice Location

4445 Magnolia Ave, Riverside, CA 92501-4135

(951) 788-3000

Unlisted Fax

Mailing Location

4445 Magnolia Ave, Riverside, CA 92501-4135

(951) 788-3000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License 326747 New York
Code 207P00000X	Description Emergency Medicine Allopathic & Osteopathic Physicians	License A178648 California
Code 207P00000X	Description Emergency Medicine Allopathic & Osteopathic Physicians	License MD-52023 Iowa

Brennan Chang

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Pandya, Devan Sanjay

Bommannan, Rishi

Gustafsson, Bo Marcus

Khan, Zara

Ng, Daniel

Hadyah, Sana

Tobar, Maria Alejandra

Woodhouse, Ernest

Kim, Mi Song

Bishop, Rebecca C.