Healthcare Provider Details

I. General information

NPI: 1205581097
Provider Name (Legal Business Name): LIU CHANG OAK FAMILY CHIROPRACTIC AND WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2022
Last Update Date: 03/20/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5335 COLLEGE AVE STE 25A
OAKLAND CA
94618-2804
US

IV. Provider business mailing address

5335 COLLEGE AVE STE 25A
OAKLAND CA
94618-2804
US

V. Phone/Fax

Practice location:
  • Phone: 408-863-2928
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: LEANA LIU CHANG
Title or Position: DOCTOR OF CHIROPRACTIC
Credential:
Phone: 510-761-1870