Provider Demographics
NPI:1780800029
Name:CHANG, LOTUS YU- CHING (LAC , PHD)
Entity type:Individual
Prefix:DR
First Name:LOTUS
Middle Name:YU- CHING
Last Name:CHANG
Suffix:
Gender:F
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 1:1822 W CHANTICLEER RD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-5519
Mailing Address - Country:US
Mailing Address - Phone:714-270-3808
Mailing Address - Fax:
Practice Address - Street 1:1822 W CHANTICLEER RD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-5519
Practice Address - Country:US
Practice Address - Phone:714-270-3808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10044171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist