Individual ProviderAndy ChangPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address8950 Villa La Jolla Dr, Ste A125, La Jolla, CA 92037(858) 452-3502PECOS EnrollmentBased on the most recent information from CMS, provider Andy Chang does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1659448694Provider TypeIndividualFull NameChang, AndyCredentialMPTGenderMaleSole ProprietorNoEnumeration Date11/28/2006Last Updated9/12/2018Contact InformationPractice LocationPractice Address8950 Villa La Jolla Dr, Ste A125, La Jolla, CA 92037Phone(858) 452-3502Fax(858) 452-3503Mailing LocationMailing Address8950 Villa La Jolla Dr, Ste A125, La Jolla, CA 92037Phone(858) 452-3502Fax(858) 452-3503Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT 30242California