MEDICARE: LIU CHANG OAK FAMILY CHIROPRACTIC AND WELLNESS 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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1205581097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIU CHANG OAK FAMILY CHIROPRACTIC AND WELLNESS INC

Provider Business Mailing Address
First Line	:	5335 COLLEGE AVE STE 25A
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94618-2804
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5335 COLLEGE AVE STE 25A
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94618-2804
Country	:	US
Telephone Number	:	408-863-2928
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR OF CHIROPRACTIC
Name	:	LEANA LIU CHANG
Credential	:
Telephone Number	:	510-761-1870

Provider Enumeration Date	:	02/20/2022
Last Update Date	:	03/20/2022

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