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General NPI Number Information
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NPI Number | 1245457563
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Entity Type | Organization
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Legal Business Name | JAMIE CHANG, D.C. CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 03/02/2012
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Provider Practice Location Address
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Address Line | 1712 BERRYESSA RD SUITE 15
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City | SAN JOSE
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State | CA
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Zip | 95133-1055
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Country | US
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Telephone | 408-937-8988
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Fax | 408-937-8222
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Provider Business Mailing Address
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Address Line | 1712 BERRYESSA RD SUITE 15
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City | SAN JOSE
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State | CA
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Zip | 95133-1067
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Country | US
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Telephone | 408-937-8988
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Fax | 408-937-8222
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JAMIE CHANG
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Credential | D.C.
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Telephone | 408-937-8988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC25202
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License Number State | CA
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