Provider Demographics
NPI:1740389329
Name:CHANG ADVANCED CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:CHANG ADVANCED CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KI WON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC FIAMA
Authorized Official - Phone:703-916-0303
Mailing Address - Street 1:7004-C LITTLE RIVER TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3201
Mailing Address - Country:US
Mailing Address - Phone:703-916-0303
Mailing Address - Fax:703-658-4881
Practice Address - Street 1:7004-C LITTLE RIVER TURNPIKE
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3201
Practice Address - Country:US
Practice Address - Phone:703-916-0303
Practice Address - Fax:703-658-4881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556012111N00000X
VA0104556321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2135960OtherKI WON CHANG UNITEDHEALTH
VA2136022OtherJONG HEE CHO UNITEDHEALTH
VA2237420OtherKI WON CHANG FIRST HEALTH
VA671263OtherJONG HEE CHO ACN GROUP
VA665262OtherKI WON CHANG ACN GROUP
VA176309OtherJONG HEE CHO ANTHEM
VAG492-0001OtherKI WON CHANG CAREFIRST
VA241137OtherKI WON CHANG KAISER
VA277952OtherKI WON CHANG ANTHEM
VA520891OtherKI WON CHANG NCPPO
VA718260OtherJONG HEE CHO NCPPO
VA254884OtherJONG HEE CHO KAISER
VAG492-0001OtherKI WON CHANG CAREFIRST
VA2136022OtherJONG HEE CHO UNITEDHEALTH
VA671263OtherJONG HEE CHO ACN GROUP
VAV04854Medicare UPIN