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General NPI Number Information
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NPI Number | 1417563487
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Entity Type | Individual
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Provider Name | PEI JU CRYSTAL CHANG L.AC
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Gender | Female
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 227 GRAND AVE STE 5
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-3449
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Country | US
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Telephone | 408-666-7607
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6047
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City | MONTEREY
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State | CA
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Zip | 93944-1047
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Country | US
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Telephone | 408-666-7607
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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 | 18828
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License Number State | CA
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