Individual
JUSTIN CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, FAAHPM
Contact information
Practice address
517 3RD ST STE 2, EUREKA, CA 95501-0460
(707) 442-5683
Mailing address
8690 SIERRA COLLEGE BLVD STE 160-306, ROSEVILLE, CA 95661-5961
(822) 332-8896
(512) 777-3130
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
DO1879
NV
207Q00000X
Family Medicine Physician
DO1879
NV
207Q00000X
Family Medicine Physician
OS016066
PA
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
20A18091
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265788228
—
NV
01
—
13526128
CAQH
—
Enumeration date
07/27/2012
Last updated
08/16/2021
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