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General NPI Number Information
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NPI Number | 1144750662
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Entity Type | Individual
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Provider Name | LUCIA CHANG L.AC.
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Gender | Female
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Dates
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Enumeration Date | 06/18/2017
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Last Update Date | 06/18/2017
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Provider Practice Location Address
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Address Line | 7974 HAVEN AVE STE 100
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3052
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Country | US
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Telephone | 714-788-9894
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 STARBUCK ST APT D205
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City | FULLERTON
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State | CA
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Zip | 92833-5680
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 15142
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License Number State | CA
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