Provider Demographics
NPI:1861658437
Name:CHANG, MANN-YOUNG (AC)
Entity Type:Individual
Prefix:
First Name:MANN-YOUNG
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 E VALLEY BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-5152
Mailing Address - Country:US
Mailing Address - Phone:626-280-4888
Mailing Address - Fax:626-280-9488
Practice Address - Street 1:33 E VALLEY BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-5152
Practice Address - Country:US
Practice Address - Phone:626-280-4888
Practice Address - Fax:626-280-9488
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8045171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist