Provider Demographics
NPI:1922489087
Name:CHANG, CHUN HSIUNG (LAC)
Entity Type:Individual
Prefix:MR
First Name:CHUN
Middle Name:HSIUNG
Last Name:CHANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:CHARLES
Other - Middle Name:
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 390382
Mailing Address - Street 2:
Mailing Address - City:MT. VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94039
Mailing Address - Country:US
Mailing Address - Phone:650-996-2128
Mailing Address - Fax:
Practice Address - Street 1:582 BORREGAS AVE
Practice Address - Street 2:ACUPUNCTURE 4 HEALTH
Practice Address - City:SUUNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-3610
Practice Address - Country:US
Practice Address - Phone:650-996-2128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist