MEDICARE: DR. JING CHUN ZHANG L.A.C.

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	AC6450	CA

General Provider Information

NPI Number	:	1487736617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JING CHUN ZHANG L.A.C.

Provider Business Mailing Address
First Line	:	655 CAMINO DE LOS MARES
Second Line	:	SUITE #125
City	:	SAN CLEMENTE
State	:	CA
Zip	:	92673-2809
Country	:	US
Telephone Number	:	949-661-1230
Fax Number	:

Provider Business Practice Location Address
First Line	:	655 CAMINO DE LOS MARES
Second Line	:	SUITE #125
City	:	SAN CLEMENTE
State	:	CA
Zip	:	92673-2809
Country	:	US
Telephone Number	:	949-661-1230
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	07/08/2007

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