Healthcare Provider Details

I. General information

NPI: 1215477450
Provider Name (Legal Business Name): SANDY CHANG L.AC., LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2017
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85-979 FARRINGTON HWY STE E
WAIANAE HI
96792-2678
US

IV. Provider business mailing address

45-468 LIPALU ST
KANEOHE HI
96744-2210
US

V. Phone/Fax

Practice location:
  • Phone: 808-391-8884
  • Fax: 808-278-9299
Mailing address:
  • Phone: 808-391-8884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU 1196
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT 4600
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: