Provider Demographics
NPI:1699915090
Name:CHANG, ALAN (ACUPUNCTURIST)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3733 ROSEMEAD BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1981
Mailing Address - Country:US
Mailing Address - Phone:626-288-3856
Mailing Address - Fax:
Practice Address - Street 1:3733 ROSEMEAD BLVD STE 102
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1981
Practice Address - Country:US
Practice Address - Phone:626-288-3856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8170171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC8170OtherACUPUNCTURE