Provider Demographics
NPI:1962641506
Name:CHANG, CHIA NING (LAC, PHD)
Entity Type:Individual
Prefix:DR
First Name:CHIA NING
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3811 SCHAEFER AVE
Mailing Address - Street 2:UNIT J
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-5400
Mailing Address - Country:US
Mailing Address - Phone:909-591-0888
Mailing Address - Fax:909-591-0889
Practice Address - Street 1:3811 SCHAEFER AVE
Practice Address - Street 2:UNIT J
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5400
Practice Address - Country:US
Practice Address - Phone:909-591-0888
Practice Address - Fax:909-591-0889
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-05
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12548171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist