MEDICARE: ACUPUNCTURE HEAVEN, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1033411657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACUPUNCTURE HEAVEN, INC

Provider Business Mailing Address
First Line	:	225 30TH ST STE 200
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-3359
Country	:	US
Telephone Number	:	916-725-8858
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 30TH ST STE 200
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-3359
Country	:	US
Telephone Number	:	916-572-8858
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES EDWARD CHANG
Credential	:	L.AC.
Telephone Number	:	916-572-8858

Provider Enumeration Date	:	12/02/2010
Last Update Date	:	12/17/2024

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