MEDICARE: TERRY CHANG ACUPUNCTURE AND HERBS 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	AC15225	CA

General Provider Information

NPI Number	:	1295194256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERRY CHANG ACUPUNCTURE AND HERBS INC

Provider Business Mailing Address
First Line	:	3060 W TEMPLE AVE
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91766-6818
Country	:	US
Telephone Number	:	909-333-6168
Fax Number	:	909-358-2068

Provider Business Practice Location Address
First Line	:	3060 W TEMPLE AVE
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91766-6818
Country	:	US
Telephone Number	:	909-333-6168
Fax Number	:	909-358-2068

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TERRY CHANG
Credential	:	L.AC
Telephone Number	:	909-333-6168

Provider Enumeration Date	:	02/18/2016
Last Update Date	:	02/18/2016

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