Healthcare Provider Details

I. General information

NPI: 1689339137
Provider Name (Legal Business Name): BARBARA CHANG CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W 4TH ST STE 204
CLAREMONT CA
91711-4707
US

IV. Provider business mailing address

201 W 4TH ST STE 204
CLAREMONT CA
91711-4707
US

V. Phone/Fax

Practice location:
  • Phone: 909-686-1877
  • Fax:
Mailing address:
  • Phone: 909-686-1877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: BARBARA CHANG
Title or Position: PRESIDENT
Credential: DC, LAC
Phone: 909-686-1877