Provider Demographics
NPI:1588736086
Name:CHANG, EUNICE LAI FUN (ACUPUNCTURIST LAC)
Entity type:Individual
Prefix:MRS
First Name:EUNICE
Middle Name:LAI FUN
Last Name:CHANG
Suffix:
Gender:F
Credentials:ACUPUNCTURIST LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1230
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754
Mailing Address - Country:US
Mailing Address - Phone:626-282-6636
Mailing Address - Fax:
Practice Address - Street 1:701 W VALLEY BLVD
Practice Address - Street 2:#86
Practice Address - City:ALAHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803
Practice Address - Country:US
Practice Address - Phone:626-282-6636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC0024080171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist