Organization
VITALITY MEDICAL INSTITUTE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDGAR JASON CHANG DC (COO)
(310) 626-1533
Entity
Organization
Contact information
Practice address
3661 TORRANCE BLVD STE 201, TORRANCE, CA 90503-4884
(310) 626-1533
Mailing address
190 E STACY RD STE 306-382, ALLEN, TX 75002-8734
(310) 626-1533
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
171100000X
Acupuncturist
—
—
204R00000X
Electrodiagnostic Medicine Physician
A84921
CA
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
A84921
CA
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
A84921
CA
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
05/27/2014
Last updated
11/30/2021
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