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General NPI Number Information
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NPI Number | 1619935632
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Entity Type | Individual
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Provider Name | EDGAR JASON CHANG D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 6888 LINCOLN AVE STE J2
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City | BUENA PARK
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State | CA
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Zip | 90620-4107
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Country | US
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Telephone | 714-828-2865
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Fax |
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Provider Business Mailing Address
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Address Line | 190 E STACY RD STE 306-382
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City | ALLEN
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State | TX
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Zip | 75002-8734
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Country | US
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Telephone | 310-381-0024
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC943
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 142065
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC28462
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License Number State | CA
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