Provider Demographics
NPI:1093041717
Name:CHANG, CINDY M (LAC)
Entity Type:Individual
Prefix:MISS
First Name:CINDY
Middle Name:M
Last Name:CHANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:HSIN-NI
Other - Middle Name:
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC, MAT
Mailing Address - Street 1:99-115 AIEA HEIGHTS DR
Mailing Address - Street 2:SUITE 277
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3924
Mailing Address - Country:US
Mailing Address - Phone:808-485-1070
Mailing Address - Fax:808-488-9301
Practice Address - Street 1:99-115 AIEA HEIGHTS DR STE 219
Practice Address - Street 2:SUITE 219
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3974
Practice Address - Country:US
Practice Address - Phone:808-485-1070
Practice Address - Fax:808-488-9301
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-30
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI598171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist