Provider Demographics
NPI:1952831331
Name:CHANG CHIROPRACTIC HEALTHCARE CLINIC
Entity Type:Organization
Organization Name:CHANG CHIROPRACTIC HEALTHCARE CLINIC
Other - Org Name:AFFINITY HEALTHCARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHIUAN-YU
Authorized Official - Middle Name:
Authorized Official - Last Name:PAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-964-9808
Mailing Address - Street 1:19031 COLIMA RD
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2922
Mailing Address - Country:US
Mailing Address - Phone:626-964-9808
Mailing Address - Fax:626-964-1088
Practice Address - Street 1:19031 COLIMA RD
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-2922
Practice Address - Country:US
Practice Address - Phone:626-964-9808
Practice Address - Fax:626-964-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty